Vaginal atrophy and laxity contribute to significant functional and psychological morbidity in postmenopausal and postpartum women. Conventional management, including hormonal therapy and surgical intervention, presents limitations such as contraindications and adverse effects. Diode laser therapy has emerged as a novel non-invasive intervention with potential regenerative benefits. This study aims to evaluate the histological, functional, and symptomatic outcomes of diode laser treatment in vaginal rejuvenation, focusing on its efficacy in enhancing collagen synthesis, epithelial proliferation, and vascularization.

A prospective, controlled study was conducted involving 100 women presenting with vaginal laxity and atrophic symptoms. Participants were randomly assigned to Group A (n=50), who underwent diode laser treatment, and Group B (n=50), who received non-hormonal lubricants as a control. The intervention protocol included three diode laser sessions at four-week intervals, utilizing a 1470 nm wavelength in fractional scanning mode. Objective assessments included high-resolution transvaginal ultrasound for measuring vaginal wall thickness, elastography for assessing biomechanical properties, and histopathological analysis of biopsied samples in a subset of patients. Subjective outcomes were evaluated using the Female Sexual Function Index (FSFI) and Vaginal Laxity Questionnaire (VLQ). Statistical analysis involved repeated-measures ANOVA and regression modeling to determine treatment effects over time.

Patients treated with the diode laser showed a significant improvement in vaginal hydration, with a 40% increase in epithelial thickness (p<0.001) and a 35% enhancement in vascular density (p<0.01). Elastographic measurements revealed a 30% increase in vaginal wall elasticity compared to baseline. Subjective assessments demonstrated a mean FSFI score improvement of 6.2 points (p<0.01) and a 45% reduction in reported vaginal dryness and discomfort. Comparative analysis with the control group confirmed the superiority of diode laser treatment, with statistically significant differences in all measured parameters. Adverse effects were minimal, with transient erythema reported in 7% of patients, resolving within 24 hours.

The findings suggest that diode laser treatment facilitates vaginal tissue remodeling through enhanced collagen synthesis and angiogenesis, leading to improved biomechanical and symptomatic outcomes. The significant increase in vaginal wall thickness and elasticity corroborates its potential regenerative effects. These outcomes indicate a mechanistic basis for the observed clinical improvements in vaginal hydration and sexual function.

Diode laser therapy is an effective, minimally invasive intervention for vaginal rejuvenation, demonstrating measurable histological and functional improvements. Further studies with long-term follow-up and larger cohorts are necessary to validate its durability and optimize treatment parameters for widespread clinical application.