The short-term outcome of laser in the management of female pelvic floor disorders: Focus on stress urine incontinence and sexual dysfunction

Lin, Hwei-Jen; Tsai, Hsiao Wen; Tsui, Kuan‐Hao; An, Ya-Fen; Lo, Ching-Chuan; Lin, Zihan; Liou, William W.; Wang, Peng-Hui

doi:10.1016/j.tjog.2018.10.010

Cited by 22 publications

(29 citation statements)

References 41 publications

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“…In the current study, we did not analyze the sexual function in these patients, and this should be emphasized in the current practice. [33] However, the subsequent analysis of quality of life after UPHOLD LITE Vaginal Support System for POP has been done. In addition, we did not provide preoperative and postoperative urodynamic examinations in all patients, contributing to the uncertain of co-existence or subsequent occurrence of de novo SUI in the current study.…”

Section: Discussionmentioning

confidence: 99%

Uterine-preserving pelvic organ prolapse surgery using the UPHOLD LITE vaginal support system

et al. 2019

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This article aims to evaluate the safety and outcome of women with pelvic organ prolapse (POP) treated by a minimally invasive bilateral sacrospinous hysteropexy (UPHOLD LITE Vaginal Support System, Boston Scientific) without concomittent anti-incontinence surgery. This retrospective study was conducted between 2014 and 2016. Evaluated items included surgical parameter and postoperative outcome. Three hundred thirteen women with POP were eligible and 22 were excluded because of history of either or more following situations, such as hysterectomy, mesh augmentation, previous anti-incontinence procedures, and radical pelvic surgery before. With a median follow-up of 26 months, surgery-related morbidity rate was 23.7% (69/291), including 1 with bladder injury (0.3%), 2 with hematoma (0.7%), 8 with urinary tract infection (2.8%), 48 with voiding dysfunction (16.5%) and 10 with mesh problems (3.4%). Among these morbidities, 12 patients (4.1%) needed surgical intervention, including 6 for mesh problems, 1 for bladder injury, 2 for hematoma, and 3 for anti-incontinence surgery. The difference of pelvic organ prolapse quantification (POP-Q) stage before and after surgery showed a statistical significance (anterior portion from 1.36 ± 2.60 to −2.69 ± 0.26, posterior portion from −1.29 ± 2.08 to −2.46 ± 0.62, and cervix portion from 2.03 ± 4.80 to −6.98 ± 2.26, all P < .001). At the end of August 2018, re-intervention rate for POP recurrence was 2.1% (n = 6), including abdominal sacrocolpopexy (n = 1), anterior repair (n = 1), vaginal total hysterectomy and uterine-sacral ligament suspension (n = 1), vaginal total hysterectomy and LeFort (n = 1), LeFort (n = 1), and pessary support (n = 1). Because some women developed postoperative lower urinary tract symptom, preoperative evaluation, including careful and detailed history taking, and urodynamic evaluation is suggested. After adequate counseling, uterine-preserving sacrospinal ligament suspension by UPHOLD LITE Vaginal Support System surgery could be considered in the management of women with POP, because of its high successful rate (97.9%) and low morbidity rate.

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Section: Discussionmentioning

confidence: 99%

Uterine-preserving pelvic organ prolapse surgery using the UPHOLD LITE vaginal support system

et al. 2019

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“…In three a significant improvement was reported in FSFI scores (P = 0.025 in Blaganje et al 22 but P-value not given in Alfarra and Altaweel 57 ), in PISQ-12 scores (P < 0.01) 22 or in self-reported 'sexual gratification'. 47 Four studies, however, did not report a significant improvement in FSFI 23,32 or PISQ-12 score. 27,33 Mohajeri et al offered women with OAB laser treatment, and also reported that their sexual function was not improved (PISQ-12).…”

Section: Sexual Functionmentioning

confidence: 94%

“…The laser types used were either Er:YAG (n = 21) or CO 2 laser (n = 9), or both, yet the outcomes are reported separately. 23 The lasers were used mainly vaginally (29 studies) and on the vulva (n = 21) and/or urethra (n = 2). 24,25 Settings of the lasers varied; however, some authors did not mention the laser settings.…”

Section: Interventionmentioning

confidence: 99%

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

Mackova

Daele

Page

et al. 2020

BJOG

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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.

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“…There is a growing demand to improve the management of FSD; consequently, non-invasive, office-based treatments, including radiofrequency and laser therapies, are gaining popularity and becoming more readily available [13,18]. Gold thread implantation (GTI) has been performed actively in the field of dermatology for some time, especially for skin tightening and wrinkle reduction [19,20].…”

Section: Introductionmentioning

confidence: 99%

Gold Thread Implantation for Female Sexual Dysfunction and Vaginal Laxity: A Preliminary Investigation

Kim

Won²,

Kim

2020

J Menopausal Med

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Objectives: We evaluated the efficacy of gold thread implantation (GTI) in the vulva and vagina to improve female sexual dysfunction (FSD) and vaginal laxity. Methods: A retrospective chart review was conducted on 46 women who underwent GTI between 2017 and 2018 at our institution. Physicians interviewed patients using questionnaires at baseline and 1-3 months post-treatment. The questionnaires consisted of eight questions: vaginal laxity, vaginal dryness, pain during intercourse, sexual satisfaction during intercourse, sexual arousal confidence, sexual satisfaction of partner, frequency, and maintaining lubrication. Results: Overall, participants experienced significant improvement after GTI treatment (P < 0.0001). The median score of vaginal laxity was 3 (slightly loose) at baseline and 5 (slightly tight) at post-treatment. Vaginal dryness also improved from 4 (moderate) at baseline to 2 (little) at post-treatment. The degree of pain during intercourse decreased from 3 to 1. The sexual satisfaction score was 3 (moderately dissatisfied) at baseline and 4 (about equally satisfied and dissatisfied) at post-treatment. Sexual confidence of arousal increased from a score of 3 (low confidence) at baseline to 4 (moderate confidence) at post-treatment. They perceived greater partner sexual satisfaction, moving from a score of 2 to 4. Participants reported lubrication was more frequent during sexual activity, which was maintained until completion of sexual activity. Both scores regarding lubrication increased from 3.5 at baseline to 5 at post-treatment. Conclusions: GTI may be an option for FSD and vaginal laxity.

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The short-term outcome of laser in the management of female pelvic floor disorders: Focus on stress urine incontinence and sexual dysfunction

Cited by 22 publications

References 41 publications

Uterine-preserving pelvic organ prolapse surgery using the UPHOLD LITE vaginal support system

Uterine-preserving pelvic organ prolapse surgery using the UPHOLD LITE vaginal support system

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

Gold Thread Implantation for Female Sexual Dysfunction and Vaginal Laxity: A Preliminary Investigation

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