First assessment of short-term efficacy of Er:YAG laser treatment on stress urinary incontinence in women: prospective cohort study

Fistonić, Nikola; Fistonić, Ivan; Lukanović, Adolf; Guštek, Štefica Findri; Turina, Iva Sorta Bilajac; Franić, Damir

doi:10.3109/13697137.2015.1071126

Cited by 83 publications

(86 citation statements)

References 20 publications

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“…Treatment response was usually assessed with validated questionnaires and showed favorable outcomes in terms of improvement of symptoms, but only one study followed patients for 24 months. None of the studies had a control or placebo group …”

Section: Stress Urinary Incontinence And/or Pelvic Organ Prolapsementioning

confidence: 99%

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The clinical role of LASER for vulvar and vaginal treatments in gynecology and female urology: An ICS/ISSVD best practice consensus document

Preti¹,

Vieira‐Baptista

Digesu³

et al. 2019

Neurourology and Urodynamics

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BACKGROUND The clinical role of LASER for vulvar and vaginal treatments in gynecology and female urology is controversial. AIMS In this best practice document, we propose recommendations for the use of LASER for gynecologic and urologic conditions such as vulvovaginal atrophy, urinary incontinence, vulvodynia, and lichen sclerosus based on a thorough literature review. MATERIALS & METHODS This project was developed between January and September 2018. The development of this document followed the ICS White Paper Standard Operating Procedures. RESULTS Most of the available studies are limited by their design; for example they lack a control group, patients are not randomized, follow up is short term, series are small, LASER is not compared with standard treatments, and studies are industry sponsored. Due to these limitations, the level of evidence for the use of LASER in the treatment of these conditions remains low and does not allow for definitive recommendations for its use in routine clinical practice. Histological evidence is commonly reported as proof of tissue regeneration following LASER treatment. However, the histological changes noted can also be consistent with reparative changes after a thermal injury rather than necessarily representing regeneration or restoration of function. The use of LASER in women with vulvodynia or lichen sclerosus should not be recommended in routine clinical practice. There is no biological plausibility or safety data on its use on this population of women. DISCUSSION The available clinical studies do not present convincing data regarding the efficacy of LASER for the treatment of vaginal atrophy or urinary incontinence. Also, while short‐term complications seem to be uncommon, data concerning long‐term outcomes are lacking. CONCLUSION At this point, LASER is not recommended for routine treatment of the aforementioned conditions unless part of well‐designed clinical trials or with special arrangements for clinical governance, consent, and audit.

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Section: Stress Urinary Incontinence And/or Pelvic Organ Prolapsementioning

confidence: 99%

“…Some evidence on the role of vaginal LASER exists for its use in urinary incontinence and pelvic organ prolapse. 4,34,77,[80][81][82][83][84][85][86] The data on its use in stress urinary incontinence comprises mainly short-term observational studies. Participants varied from 19 to 205 women.…”

Section: Incontinence And/or Pelvic Organ Prolapsementioning

confidence: 99%

The clinical role of LASER for vulvar and vaginal treatments in gynecology and female urology: An ICS/ISSVD best practice consensus document

Preti¹,

Vieira‐Baptista

Digesu³

et al. 2019

Neurourology and Urodynamics

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“…Similarly, claims that vaginal laser is a treatment option for women with vulvodynia and lichen sclerosus is again not supported by scientific evidence, lacks biological plausibility, and can cause potential harm. The appeal of vaginal laser treatment as an office procedure for female pelvic organ prolapse, the so called “vaginal relaxation syndrome” and stress urinary incontinence has also been explored . There is minimal published data with the recurring theme of paucity of good quality evidence in the form of multi‐center randomized placebo‐controlled trials, which is concerning.…”

Section: Introductionmentioning

confidence: 99%

“…The appeal of vaginal laser treatment as an office procedure for female pelvic organ prolapse, the so called "vaginal relaxation syndrome" and stress urinary incontinence has also been explored. [19][20][21][22][23][24][25][26][27][28][29] There is minimal published data with the recurring theme of paucity of good quality evidence in the form of multi-center randomized placebo-controlled trials, which is concerning.…”

mentioning

confidence: 99%

The energy based devices for vaginal “rejuvenation,” urinary incontinence, vaginal cosmetic procedures, and other vulvo‐vaginal disorders: An international multidisciplinary expert panel opinion

Digesu

Tailor

Preti

et al. 2019

Neurourology and Urodynamics

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Aims Energy‐based devices using radiofrequency and laser technologies have gained popularity as therapies for vaginal atrophy, urinary incontinence, and vaginal prolapse. They have been promoted by cosmetic and aesthetic industries for vaginal “laxity” and vaginal “rejuvenation,” both of which are undefined conditions and terms. This article aims to review the current available literature and its quality on this emerging technology. Methods An international panel of gynaecologists, urogynaecologists, and urologists undertook a review of the available published literature, identifying articles, guidance, and society statements on the use vaginal energy‐based devices. Results There is currently no formal guidance for the use of vaginal energy based therapies. No randomized controlled trials have been published. No comparative studies to existing treatment has been carried out. Studies suggest that vaginal laser can be used in the treatment of vaginal prolapse or “vaginal laxity” and stress urinary incontinence with no quality evidence supporting the use of the therapy for vaginal atrophy or lichen sclerosis. Conclusions This international group propose that whilst there remains a paucity of good quality data describing the safety, benefits, and appropriate use of vaginal radiofrequency or laser treatments in gynaecology and urogynaecology, a consensus best practice document by an established scientific community needs to be developed.

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“…Away from VVA, there have been a number of studies reporting symptomatic improvement in women with mild USI with both the erbium and CO 2 lasers 7,11 . This may be an effect of the increased collagen remodeling provoked by the laser but, at this stage, the data are not robust enough to be able to draw any significant conclusions.…”

mentioning

confidence: 99%

Turning the spotlight on lasers

Hillard¹

2017

Climacteric

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First assessment of short-term efficacy of Er:YAG laser treatment on stress urinary incontinence in women: prospective cohort study

Abstract: This study of Er:YAG laser therapy in women has demonstrated a clinically relevant, short-term improvement of stress urinary incontinence, with minimal adverse events of a transient nature.

Cited by 83 publications

References 20 publications

The clinical role of LASER for vulvar and vaginal treatments in gynecology and female urology: An ICS/ISSVD best practice consensus document

The clinical role of LASER for vulvar and vaginal treatments in gynecology and female urology: An ICS/ISSVD best practice consensus document

The energy based devices for vaginal “rejuvenation,” urinary incontinence, vaginal cosmetic procedures, and other vulvo‐vaginal disorders: An international multidisciplinary expert panel opinion

Turning the spotlight on lasers

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