Fractional CO2 laser for treatment of stress urinary incontinence

Abstract

Objectives To evaluate the impact of trans-vaginal fractional CO 2 laser treatment on symptoms of stress urinary incontinence (SUI) in women. Study design Women clinically diagnosed with SUI preferring non-surgical treatment were recruited to the study. Fractional CO 2 laser system (MonaLisa T, DEKA) treatments were administered trans-vaginally every 4–6 weeks for a total of three treatments. Response to treatment was assessed at baseline (T1), at 3 months after treatment completion (T2) and at 12–24-month follow-up (T3) using the Australian Pelvic Floor Questionnaire (APFQ). The primary outcome was changes in reported symptoms of SUI. Secondary outcomes assessed included bladder function, urgency, urge urinary incontinence (UUI), pad usage, impact of urinary incontinence on quality of life (QOL) and degree of bothersome bladder. Results Fifty-eight women were recruited and received the study treatment protocol. Eighty-two percent of participants reported an improvement in symptoms of SUI at completion of treatment (mild to no SUI) (p = <0.01). Treatment effect waned slightly when assessed at follow-up. Nevertheless, 71% of participants reported ongoing improvement in SUI symptoms at 12–24 months (p < 0.01). All secondary outcome measures were improved after treatment compared to baseline. Conclusions This study suggests that fractional CO 2 laser is a safe, feasible, and beneficial treatment for SUI and may have a role as a minimally-invasive alternative to surgical management.

Fractional‐Pixel CO2 Laser Treatment in Patients With Urodynamic Stress Urinary Incontinence: 1‐Year Follow‐Up

“…Vaginal application of CO 2 laser has been recently introduced for medical conditions related to the vaginal epithelium. Most of the studies on vaginal CO 2 laser have been performed for various symptoms under the newly defined broad term “genitourinary syndrome of menopause” (GSM) [7–9] and very few have assessed the efficacy in patients with SUI [10–14]. The promising outcome of SUI treatment in these prospective studies was short term, namely 3–4 months [14], 6 months [13], or slightly longer [11,12].…”

Pixel CO2 Laser for the Treatment of Stress Urinary Incontinence: A Prospective Observational Multicenter Study

“…In the study conducted by Gonzalez [11] involving 161 women who underwent scanner‐fractional CO 2 laser treatment, the authors reported statistically significant improvement in ICIQ‐UI‐SF scores and 1‐hour pad weight test at 12, 24, and 36 months ( P < 0.001). Behnia‐Willison et al [12] studied the effect on 58 women and an improvement (mild‐to‐no SUI) reported in 82% of the women at the completion of treatment, but the improvement waned slightly at follow‐up. Lin et al [26] included 31 women in the study; 21 were treated with Er:YAG and 10 women with CO 2 laser and both treatment protocols seemed to be useful for the improvement of SUI symptoms.…”

“…Most studies have referred to the use of nonablative Er:YAG laser for the treatment of SUI [7–9], and one study specified its use for SUI and mixed urinary incontinence (MUI) [10]. CO 2 lasers have been commonly used in clinical practice; however, recently, they have been found to be a valid treatment option for SUI as well [11–14].…”

A non-randomized chlinical trial The effect of pelvic floor exercises at home and electrical stimulation plus biofeedback in hospital in management of stress urinary incontinence of primiparas in short-term postpartum period

“…2.Our questionnaire on SUI is too simple. Australian Pelvic Floor Questionnaire includes 15 items to reflect Bladder Function [25] , which should be referenced.…”