RF or CO2 - which procedure would deliver results and target vaginal laxity, decreased sensation and early posterior prolapse?

Vaginal laxity aka a loose vagina that lacks friction during sex is the result of loose and damaged vaginal muscles and vaginal supports. Nonsurgical vaginal technologies and devices, all of them, target the skin. They don't target the muscles and vaginal supports because they can't. These structures are too deep for these technologies to have any effect on them. So what happens when these treatments are done is that skin tightening is temporarily achieved over a layer of loose and broken muscles. Since the skin has little if any strength, the skin tightening effect goes away after a few rounds of sex and you're back to the same looseness that you started with. The only that works in 2023 is surgery. That surgery is called vaginoplasty.

Great question!
So, you have a stage 2 rectocele and are looking for non-surgical options to improve your sexual experience. The best treatment depends on your anatomy, exam, symptoms, age, and expectations.
If you want to look and feel as tight as you did before your first vaginal delivery, then perhaps surgery is ultimately your best option.
If your sex is good, but want it better without going through surgery, then non-surgical vaginal rejuvenation is an excellent option for the forseeable future. Eventually in 3-5-10 years you may decide that surgery is warrnated. These treatments will not reduce your prolapse.
In older women, 40 and up, who are experiencing vaginal dryness and less lubrication the Femilift CO2 laser is excellent for this. This will also reduce stress incontinence and improve laxity.
If you have decreased sensation and urinary leakage without so much vaginal dryness then the Viveve RF treatment is good for this.
If you are having difficulties with orgasm, where it takes longer, or you don't have vaginal orgasms then the O-Shot would be helpful.
In my practice, most women who have all of the above complaints will do combination treatments and have a series of CO2 laser treatments with a Viveve RF treatment and an O-Shot. They then repeat these annually. Most avoid surgery this way fro many years.
You should consult with a Urogynecologist experienced in reconstructive and cosmetic vaginal surgery, as well as vaginal rejuvenation who could determine if you are a good candidate.
Go to the link below to become more familiar with these treatments. From that link you can schedule a virtual consultation via phone or zoom, at which time we can discuss in depth your anatomy, expectations and concerns.
Best of luck,

The laser is going to give you a much better result than RF. I am partial to the Mona Lisa Touch laser as it is the most powerful, using fractionated carbon dioxide laser technology. This is why only medical providers (MD/DO/NP) are licensed to use this. I have this in my clinic and I have seen impressive improvements in sensation and especially lubrication.
However, it is important to have realistic expectations. If you have significant prolapse, only surgery will reverse this. If a clinic tells you that their laser/RF will fix your prolapse, ask for before and after photos. We do not have before and after photos on our website because the results are more what you can feel than see.