Vaginal therapy of mild and moderate stress urinary incontinence using Er:YAG laser: a real treatment option

Reisenauer, Christl; Hartlieb, Sebastian; Schoenfisch, Birgitt; Brucker, Sara; Neis, Felix

doi:10.1007/s00404-019-05334-2

Cited by 13 publications

(25 citation statements)

References 13 publications

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“…This may be related to a lower baseline ICIQ-SF and 1-hour pad test in milder SUI cases, limiting the scope for improvement. SUI patients also evidently benefited more from laser treatment than MUI or patients with other UI types (9,15,16,18,21,24,27). Statistical analyses of SUI and patients with other UI types or symptoms could not be separately performed, due to the limited amount of clinical information.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of vaginal laser therapy for stress urinary incontinence: a meta-analysis

Wang¹,

Wang²,

Song³

et al. 2021

Ann Palliat Med

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Background: Laser therapy has recently been proposed as a novel treatment for stress urinary incontinence (SUI) due to offering several advantages. This study aimed to evaluate the safety and efficacy of laser treatment of SUI by a meta-analysis. Methods:The systematic review registration number is INPLASY202080001. A comprehensive search to identify relevant studies was conducted using the PubMed, Embase, Cochrane Library, CNKI, VIP and Wanfang databases with a cutoff date of 1 November, 2020. Outcome measures were extracted based on subjective and objective indexes, including International Consultation on Incontinence Questionnaire-Short Form (ICIQ-UI-SF), Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12), and objective measurements "1-hour pad test" (1-hour test under standardized conditions). Score changes before and after treatment were evaluated through meta-analysis. Subgroup analysis was performed according to geographic region, type of urinary incontinence (UI), severity of UI, age, and body mass index (BMI).Results: Sixteen published clinical research studies, involving 899 patients with SUI, were included in this study. After laser treatment, the change in the ICIQ-SF score at 1, 2, and 6 months was −5.49 (95%

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Section: Discussionmentioning

confidence: 99%

Safety and efficacy of vaginal laser therapy for stress urinary incontinence: a meta-analysis

Wang¹,

Wang²,

Song³

et al. 2021

Ann Palliat Med

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“…So far, only five peer‐review studies on CO 2 laser for treating SUI [8–11,26] have been published, and all of them used fractional‐scanning CO 2 laser technology. As such, discussing the effect of fractional‐pixel CO 2 laser technology is relevant.…”

Section: Discussionmentioning

confidence: 99%

“…Since 2015, many clinical studies have shown the advantages of different energy‐based devices (EBD) for the treatment of SUI/genitourinary syndrome of menopause (GSM), mainly Er:YAG and carbon dioxide (CO 2 ) laser [6]. 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].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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Background and Objectives Energy‐based treatments have been found to be a promising treatment modality for improving stress urinary incontinence (SUI) symptoms. This prospective two‐center study was designed to evaluate the efficacy of fractional‐pixel CO2 laser for the treatment of SUI. Study Design/Materials and Methods Eighty‐five women with SUI symptoms as per the cough stress test and validated International Consultation on Incontinence Questionnaire—Urinary Incontinence Short Form (ICIQ‐UI‐SF), were treated intravaginally with Pixel‐CO2 laser. Two treatment sessions were performed with a 1‐month interval. Safety and treatment tolerance were assessed by the visual analog scale (VAS) immediately and at 1 week after each laser treatment. Associations of age and body mass index (BMI) with the ICIQ‐UI‐SF score were statistically assessed by the Jonckheere–Terpstra test. Results The ICIQ‐UI‐SF score was 12.0 at baseline, 7.0, after the first treatment, and 3.5 after the second treatment (P = 0.001). For women with BMI (25.0–29.9), the ICIQ‐UI‐SF score was 9.0 at the baseline, 6.0 after 1 month, and 5.0 at the 6 months follow‐up visit (P = 0.04). For women with BMI ≥ 30.0, the ICIQ‐UI‐SF score was reduced from 14.0 to 8.0 1 month after the baseline and 5.0 at the 6‐month follow‐up visit (P = 0.001). SUI severity evaluation at baseline showed that 27.1% of women had mild, 24.7% had moderate, 45.9% had severe, and 2.4% had very severe SUI symptoms. SUI severity scores were significantly reduced, with 45.8% of women with no SUI symptoms, 18.8% with mild, 20.8% with moderate, and 14.6% with severe SUI symptoms at the 6‐month follow‐up. The patient's evaluation of VAS after the first treatment was 1.0–1.5 (0–10) and 0.0 1 week after the second treatment. Conclusion Fractional‐pixel CO2 laser is safe and effective for treating SUI. No adverse event or significant pain was reported during or after the procedure. Its safety and efficacy are clearly demonstrated. Lasers Surg. Med. © 2020 Wiley Periodicals LLC

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“…On evaluation at 3 and 6 months post-treatment, VAS and VHI improved in both groups but significantly more improved in the group treated with laser [19•]. A more recent prospective cohort study by Reisenauer et al [49] reported that among patients (N=30) receiving two treatments with Er: YAG laser therapy, patients reported a significant improvement in QOL, which had previously not been reported. [38].…”

Section: Erbium:yttrium-aluminum-garnetmentioning

confidence: 97%

“…Clinical studies of efficacy of Er:YAG for functional vaginal problems have primarily been limited to prospective cohort studies thus far. Multiple prospective cohort studies have reported effectiveness of the Er:YAG laser in management of vaginal laxity, GSM, sexual dysfunction, and SUI (Table 2) [19,20,25,26,48,49]. One study performed by Gambacciani et al [19•] compared Er:YAG laser to vaginal estrogen therapy for treatment of GSM (N=70).…”

Section: Erbium:yttrium-aluminum-garnetmentioning

confidence: 99%

Energy-Based Devices for Functional Vaginal Problems: Issues and Answers

Bujnak

Crowder

Krychman

2021

Curr Sex Health Rep

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Vaginal rejuvenation is a marketing term that encompasses surgical and medical treatments for functional vaginal/vulvar problems including but not limited to genitourinary syndrome of menopause (GSM), sexual dysfunction, vaginal laxity, and stress urinary incontinence (SUI) and for esthetic concerns including dissatisfaction with vulvovaginal appearance. Multiple treatment options have become available for indications of functional vaginal problems. Noninvasive management options including the use of more novel treatments such as energy-based devices have gained interest. Previously, studies regarding the efficacy and safety of the energy-based devices for functional vaginal problems were mostly limited to cohort studies without sham treatment, control groups, randomization, or double blinding. As a result of this insufficient data in 2018, the FDA released a statement of warning against the use of energy-based devices in the treatment of functional vaginal problems or vaginal cosmetic procedures (Https://Www.Fda.Gov/Medical-Devices/Safety-Communications/Fda-Warns-Against-Use-Energy-Based-Devices-Perform-Vaginal-Rejuvenation-or-Vaginal-Cosmetic. 1–4, 2018). Purpose of Review This article reviews the most current treatment modalities in the realm of vaginal rejuvenation therapy with an emphasis on the efficacy and safety of the energy-based devices. Recent Findings In the most recent literature, there have been studies with improvements in study design that support the efficacy and the short-term safety of the energy-based devices. Summary More recent studies with improved study design evidence that the use of energy-based devices results in improvements in functional vaginal problems and that serious adverse events appear to be rare. The availability of these devices as treatment options for functional vaginal problems has the potential to impact patient by improving their symptoms and quality of life. Caution still remains however regarding their safety following a longer period of time after their use.

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Vaginal therapy of mild and moderate stress urinary incontinence using Er:YAG laser: a real treatment option

Cited by 13 publications

References 13 publications

Safety and efficacy of vaginal laser therapy for stress urinary incontinence: a meta-analysis

Safety and efficacy of vaginal laser therapy for stress urinary incontinence: a meta-analysis

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

Energy-Based Devices for Functional Vaginal Problems: Issues and Answers

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Vaginal therapy of mild and moderate stress urinary incontinence using Er:YAG laser: a real treatment option

Cited by 13 publications

References 13 publications

Safety and efficacy of vaginal laser therapy for stress urinary incontinence: a meta-analysis

Safety and efficacy of vaginal laser therapy for stress urinary incontinence: a meta-analysis

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

Energy-Based Devices for Functional Vaginal Problems: Issues and Answers

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Product

Resources

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