Fractional CO2 laser therapy holds potential for treating the Genitourinary Syndrome of Menopause (GSM). However, it remains controversial in female pelvic medicine. Here, we developed a non-invasive intravaginal OCT/OCT angiography (OCTA) endoscope. This system can simultaneously obtain both structural and vascular information during vaginal laser procedures. Our clinical research involved 25 post-menopausal GSM patients and took OCT/OCTA scans from four distinct vaginal regions throughout treatment sessions. With the help of deep learning, we measured Vaginal Epithelial Thickness (VET). We used OCTA to monitor Blood Vessel Density (BVD) and track vascular densification. We also conducted long-term follow-up experiments to assess the subsequential efficacy of laser treatment. Additionally, involving 45 women of varied menopausal stages, we analyzed their VET, BVD, and self-test scores to quantify the correlation between objective and subjective parameters. Our OCT/OCTA endoscope provides a noninvasive biopsy tool for gynecological research, aiding clinicians in evaluating tissue responses to laser treatments.
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