The Efficacy of Fractional Co2 Laser Treatment for the Treatment of Overactive Bladder Syndrome in Menopausal Women- A Three Month Pilot Study

Abstract

BACKGROUND Overactive bladder syndrome (OABS) is a common disorder that encompasses urgency, frequency, and nocturia. Various methods of therapies have been utilized worldwide. Despite progresses, it remains a formidable challenge. Laser treatment has emerged to reliably treat the symptoms complex. This study was intended to evaluate the effect of fractional CO2 laser on the main symptoms of OABS. MATERIALS AND METHODS A prospective pre-and post-intervention pilot study was conducted on 31 female subjects recruited from a general hospital in Tehran, Iran. They were treated with 3 laser applications at one-month interval using the intravaginal fractional micro-ablative CO2 laser. The study measures were urgency, frequency, nocturia, leakage, International Consultation on Incontinence Overactive Bladder (ICIQ-OAB), Urogenital Distress Inventory Short Form (UDI-6), and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12), which were examined at baseline and every month thereafter up to the end of the laser treatment sessions. RESULTS The findings indicated that statistically significant differences occurred in the ICIQ-OAB score and urgency during treatment sessions as compared to the baseline (p<0.05). Laser therapy led to marked improvements in the UDI-6 score only at month 3 (p=0.001). Nocturia, frequency, leakage, and PISQ-12 score did not ameliorate upon laser administration (p>0.05). CONCLUSION In this pilot study, it was found that fractional CO2 laser could be effective in the amelioration of some OABS symptoms in menopausal women. Further investigations with a larger sample size and long-term follow-ups are required to substantiate these preliminary findings.

Physical methods for the treatment of genitourinary syndrome of menopause: A systematic review

“…After reviewing the full‐text articles, an additional 20 records were excluded. This process resulted in 49 articles, 1,2,4,13‐58 which were further reviewed using a hand‐searching approach. Table 2 displays all the selected studies.…”

“…Table 2 displays all the selected studies. Of these, 37 were about the CO 2 laser, 1,2,4,13,14,17‐19,22‐27,29‐31,33‐37,39,42,45‐47,49‐58 10 were about the Erbium laser, 15,16,20,32,38,40,41,43,44,48 and two were about radiofrequency 21,28 . Outcomes of the studies included in the systematic review are shown in Table 3.…”

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

“…27,33 Mohajeri et al offered women with OAB laser treatment, and also reported that their sexual function was not improved (PISQ-12). 54 Alkhafajy and Alyaseen observed improved sexual function using a subjective three-grade scale in women with vaginal relaxation (P = 0.004). 26 In one study in women with GSM there was a significant improvement in FSFI scores in all participants (P < 0.001) 53 and in another in 35 out of 40 participants (P < 0.001).…”

“…28 There were three other GSM studies in which women with unspecified incontinence were included showing significant improvement on the ICIQ-UI SF scores at 4 weeks of follow up (P < 0.001) 42 and 12 months of follow up (P < 0.001), 53 as well as a satisfaction rate of 75%. 43 Three studies addressed urge incontinence primarily, 31,54,55 but in combination with GSM in one. 55 A significant improvement in the ICIQ-OAB score was measured after the first treatment (P < 0.05) 54 and lasted up to 30 days post treatment (P < 0.0001).…”

“…43 Three studies addressed urge incontinence primarily, 31,54,55 but in combination with GSM in one. 55 A significant improvement in the ICIQ-OAB score was measured after the first treatment (P < 0.05) 54 and lasted up to 30 days post treatment (P < 0.0001). 55 There was no longer follow up available.…”