CO2RE Intima

New Minimally Invasive Procedure with No Pain or Downtime… From Ann Arbor’s own, Dr. Kathleen Gilmore.

  • Laser Vaginal Tightening for Improved Sexual Pleasure and Relief from Minimal Urinary Incontinence
  • Laser Vaginal Therapy for reversing Vaginal Atrophy (Good also for Breast Cancer Survivors with Vaginal Atrophy)

Vaginal laxity is a common complaint in sexually active women. Although the change in sexual pleasure may be subtle in some cases, it may be drastic in others to the point of significantly affecting personal relationships and/or marriages. Some women may also experience involuntary loss of urine during exercise, laughing, coughing, and even during sex – this is referred to as stress urinary incontinence. Until recently, the only options have been Kegel exercises or surgery.  Although Kegels are important to strengthen the pelvic floor they are often insufficient. Surgery in the form of a Vaginaplasty to tighten the vagina, or a mid-urethral sling to support the urethra to control leakage, are good options, but they are associated with risks and the need for downtime. Recent technological advances have introduced new methods for little to no downtime** effective options for treating vaginal laxity and mild stress urinary incontinence.

What is CO2RE Intima?

A non-surgical, painless 15-minute office procedure utilizing reliable third-generation CO2 fractional Laser technology delivered into the vagina via a vaginal-shaped probe. The procedure consists of 3 treatments over 12 weeks, with a “touchup” one year later. The results are a noticeable tightening of the entire vaginal barrel for increased friction and pleasure during sexual intimacy. If utilized in a different power mode, CO2RE Intima is also quite effective in reversing the atrophic effects of aging in the vagina.

What does CO2RE Intima accomplish (for vaginal tightening)?

CO2RE Intima works via pulses of laser energy into the collagen layer of the vaginal mucosa, where concentrated thermal heating leads to collagen and elastin “shrinkage” and secondary regeneration, producing a tightening of the vaginal tissues. The initial shrinkage and secondary regeneration produce improved pressure on the “G-Spot” and increase the stretch of the internal bulbs and crurae of the internal portion of the clitoris. Tightening also occurs along the base of the overlying bladder, with evidence shows that it also improves the pesky problem of minor urinary incontinence.

The outcome of this procedure is the complete remodeling of the vaginal mucosa, in addition to the re-establishment of robust “younger-seeming” vaginal tissue embedded with thick and long collagen fibers.

What does CO2RE Intima accomplish (for vaginal atrophic changes)?

By altering and rearranging collagen fibers, enabling the formation of elastin and better collagen formation, Core Intima can provide long-term reversal of the atrophic effects of aging on the vaginal walls.

How does Co2RE Intima work?

A laser generator produces safe pulses of patterned pixel-screen laser energy delivered via a tube-shaped intra-vaginal device. These pulses generate laser beams in a grid less than ½ mm apart and 0.6 mm deep via a microscopic laser-produced opening at intervals of several millimeters into the collagen under the dermis (the layer just underneath the vaginal skin). This causes a 360° symmetrical micro-contracture of the entire vaginal barrel, leading to overall tightening in the case of laxity, including tightening of the upper vagina, producing added support for the base of the bladder. In a different power mode, CO2RE Intima may be utilized solely to stimulate collagen and elastin formation to enable better “stretchability” of the vaginal tissues.

Who is a good candidate for this procedure? Who is not?

Candidates: Women with minimal to moderate vaginal looseness or laxity not severe enough to need a complete surgical repair (“Vaginoplasty”), but bothersome enough (less “grip,” too much “droop”) to diminish sexual pleasure and sometimes lead to modest urinary incontinence. Perfect candidates are:

  1. Women who have not yet had a child but either feel themselves “wide” inside or have a partner with a smaller-sized penis.
  2. Women with laxity after childbirth who plan on another child/children and need “temporary” tightening until their final childbirth, after which they may undergo a permanent surgical tightening procedure if the problem persists.
  3. Women who will undergo a Vaginoplasty (surgical tightening procedure) of the outer (lower) half of the vagina/vaginal floor, but also have noticeable widening in the far inner (upper) vagina (where a surgical pelvic floor tightening procedure traditionally cannot reach), which frequently occurs with a coexisting problem of occasional involuntary loss of urine, and who wish to avoid an in-hospital general anesthesia, which is sometimes risky for upper-vaginal repair.
  4. Women with mild urinary incontinence.
  5. Women with only modest vaginal laxity and decent musculature, who wish to avoid a surgical procedure.
  6. Post-menopausal women with dry, atrophic vaginal tissues.
  7. Laser Vaginal Tightening is safe for most women, including those with other vaginal concerns such as pelvic relaxation, vaginal prolapse, stress urinary incontinence, endometriosis, and pelvic pain.
  8. It is ideal for women who have recently given birth and are breastfeeding, especially if they want to have more children.  It is recommended to wait 3 months after childbirth to have the procedure. Women may use all forms of birth control including an IUD, or have had previous pelvic surgery such as a vaginal repair or hysterectomy.  Many women begin laser hair removal treatments during their CO2RE Intima treatments or combine Co2RE Intima with other Feminine Rejuvenation options.

Not Candidates:

  1. Women with a significant pelvic floor vaginal laxity involving significant widening and muscular separation; these women need a surgical repair and will be disappointed with a solely laser procedure.
  2. Women with significant urinary incontinence and/or prolapse; these women need a surgical repair/“sling” or “tape” procedure.
  3. Women with very tightened, atrophic vaginas; these women will first need to undergo re-estrogenization and mild mechanical dilation in order to physically accommodate the treatment probe.

What is the science behind this procedure?

The Intima laser utilizes Fractionated CO2 pulsed light wave technology as a cutting, tightening or resurfacing tool. In this instance, non-ablative laser waves exiting the tube at closely spaced intervals “drill” microscopic, closely spaced micro-punctures 0.6 mm (600 microns) into the dermis, producing a mini-defect in the collagen that contracts, producing shrinkage (in proper power settings) and stimulating the collagen and elastin to grow, thus bulking and “rejuvenating” this layer. This technology has been utilized in Europe and Asia for more than 5 years, and a wealth of data has accumulated verifying its effects and success.

How long does the CO2RE Intima treatment benefits last?

Present data suggest that, with 3 treatments over a 12-week time period and especially with a “touchup” after one year, the tightening and continence effects are experienced for at least 2-3 years or more, while the atrophic elasticity effects are ongoing with no need for further treatments in properly managed patients.

I have read about other vaginal treatments; why is CO2RE Intima better or different?

CO2RE Intima is FDA cleared to treat all three areas of a women’s intimate needs (external, internal and introitus) and with hygienic, single-use hand pieces, thereby assuring women of the results and hygiene they expect for treatments to their most intimate area. Additionally, CO2RE Intima utilizes a CO2 laser. CO2 lasers have been proven to remodel tissue with neoformation of collagen and elastic fibers in atrophic skin. CO2 technology also provides physicians with the ability to treat both superficial and deep skin layers simultaneously and with the precision control they need over the intensity, pattern and depth of ablation, which is very important for treatments to this intimate area.

Other unique uses of this technology

Co2 Fractionated Laser technology may also be used to:

  1. Re-surface stretch marks and surgical scars.
  2. “Bleach” darkened peri-vaginal and peri-anal skin.

How much does it cost? Are there any discounts available?

The full price is $2,7000-$3,000 for the series of 3 treatments, plus $900 for a once yearly maintenance treatment.

Disclaimer:

This is new technology. Although it has been cleared by the FDA, FDA approval of “medical devices,” unlike medications, is not necessarily an exhaustive process. While it appears, from a limited number of studies, that both laser tightening and relief from vaginal atrophy accomplishes what it promises with little risk of harm, there really are no well-controlled long-term (over 2-3 years) studies like there are for surgical procedures. Surgery remains the “gold standard” for vaginal tightening, but laser treatment may offer benefits in certain situations (see above.) Vaginal estrogen therapy remains the “gold standard” for vaginal health rehabilitation, but there are situations where laser treatment may offer advantages. Individual results cannot be guaranteed, and my vary.

References:

  • “Novel Minimally Invasive VSP Er:YAG Laser Treatments in Gynecology.” Vizintin, Rivera, Fistonic, Sercaglu, Guimares, et al. Journal of the Laser and Health Academy, 2012.
  • “A 12-Week Treatment with Fractional CO2 Laser for Vulvovaginal Atrophy: A Pilot Study.” Salcatore, Nappi, Zerbinati, Calligaro, Ferrero, et al. Climateric, 2014
    “Histological Study on the Effects of Microablative Fractional CO2 Laser on Atrophic Vaginal Tissue: An Ex Vivo Study.” Salvatore, Maggiore, Athanasiou, Origoni, Candiani, et al. Menopause, 2015
  • “Treatment of Vaginal Relaxation Syndrome with an Erbium:YAG Laser Using 90° and 360° Scanning Scopes: A Pilot Study & Short-term Results.” Lee. Laser Therapy, 2014
  • “Vulvo-Vaginal Atrophy: A New Treatment Modality Using Thermo-Abative Factional CO2 Laser.” Perino, Calligaro, Forlani, Tiberio, Cucinella, et al. Maturitas, 2015.

**The results may vary for different people.