Female urinary incontinence: is laser treatment effective? a systematic review

Abstract

Background: Towards the recent promising results of microablative fractional CO 2 -laser and non-ablative photothermal Erbium: YAG-laser (Er:YAG-laser) as therapy performed in Gynaecology; this systematic review aims to summarize the effectiveness and safety of both laser technologies on female Urinary Incontinence (UI). Methods:Using "laser" and "urinary incontinence" as query, studies were searched from MEDLINE and SCOPUS up to February 2018. Information from seventeen studies, counting more than 892 female patients with UI, was systematically registered. 652 and more than 240 patients were treated with Er:YAG-laser and CO 2 -laser, respectively. Results:Results addressing patient reported outcomes through different validated questionnaires showed statistically significant improvement in UI after Laser therapy. Pad weight tests, perineometry, Q-tip test, urodynamics and epithelial biopsies as assessment to objective quantification of UI and pelvic structures remodeling also showed improvement but these results were not so consistent. In general, laser therapy was well tolerated and no major side effects were reported. Conclusion:Laser therapy seems to be a promising alternative approach to UI in women. However, there are no randomized controlled trials in this field and so the level of evidence is still low. More research is required to further apply these technologies in women safely and effectively.