Laser therapy for urinary incontinence and pelvic organ prolapse: a systematic review

Abstract

Background Laser therapy is now being proposed for the treatment of pelvic organ prolapse (POP) and urinary incontinence (UI). Objectives To systematically review the available literature on laser therapy for POP and UI. Search strategy PubMed, Web Of Science and Embase were searched for relevant articles, using a three‐concept (POP, UI, laser therapy) search engine composed as (concept 1 OR concept 2) AND concept 3. Selection criteria Only full‐text clinical studies in English. Data collection and analysis Data on patient characteristics, laser setting, treatment outcome and adverse events were independently collected by two researchers. There was a lack of methodological uniformity so meta‐analysis was not possible and the results are presented narratively. Main results Thirty‐one studies recruiting 1530 adult women met the inclusion criteria. All studies showed significant improvement either on UI, POP or both; however the heterogeneity of laser settings, application and outcome measures was huge. Only one study was a randomised controlled trial, two studies were controlled cohort studies. All three were on UI and used standardised validated tools. The risk of bias in the randomised controlled trial was low on all seven domains; the controlled studies had a serious risk of bias. No major adverse events were reported, mild pain and burning sensation were the most commonly described adverse events. Conclusions All studies on vaginal and/or urethral laser application for POP and UI report improvement, but the quality of studies needs to be improved. Tweetable abstract There is weak evidence that laser therapy is effective for urinary incontinence and pelvic organ prolapse #LASER#UI#POP.

Comparison of urethral sling surgery and non-ablative vaginal Erbium:YAG laser treatment in 327 patients with stress urinary incontinence: a case-matching analysis

“…The incidence of de novo urgency at 1 year after TVT was reported to be 22.2% [28]. On the other hand, VEL was not reported to generate de novo urgency or any serious major adverse events [29]. Notably, VEL is inferior to TVT with respect to the time that it took to obtain a cure.…”

The Emerging Role on the Use of Platelet-Rich Plasma Products in the Management of Urogynaecological Disorders

“…Pelvic organ prolapse has a significant impact in the quality of life of women with a prevalence of approximately 5–10%. 13 Surgical repair is considered when conservative modalities such as physiotherapy and pessaries have failed to improve symptoms. 13 Pelvic organ prolapse has been associated with significantly decreased collagen concentration compared to healthy controls.…”

Therapieoptionen der weiblichen Belastungsharninkontinenz

“…Die Heterogenität der Laser, der Art der Anwendungen und auch die der Erfolgskriterien war zu groß, als dass man die Studien vernünftig vergleichen könnte. Ebenso scheint eine Überprüfung der Studienqualität notwendig [39]. Insgesamt jedoch handelt es sich um innovatives, möglicherweise Erfolg versprechendes Verfahren bei geringgradiger Harninkontinenz, dass einer weiteren Überprüfung jedoch dringend bedarf [40].…”