Pixel-CO2 laser for the treatment of stress urinary incontinence

Abstract

The aim of this study was to assess the safety and efficacy of a minimally invasive pixel-CO2 laser procedure for the treatment of stress urinary incontinence (SUI). This was a prospective, open-label study with a cohort of 59 women. Patients were treated intravaginally with a fractional/pixel CO2 laser every 4–6 weeks for a total of three treatments and assessed at 3, 6, and 12 months. Evaluation tools included a Sandvik severity score based on a validated questionnaire, 1-h pad test, vaginal health index score (VHIS), validated female sexual function index (FSFI), patient’s impression of disease severity (PGI-S), global impression of improvement (PGI-I), and the short-term pelvic floor impact questionnaire (PFIQ-7) to assess improvements in quality of life. Reduction in SUI severity was noticed throughout the duration of the study, as compared to the baseline in which 2% of the patients were defined as “slight,” 73% “moderate,” and 25% “severe.” Gradual improvement of symptoms resulted in redistribution of severity score and the best outcome observed between 3 and 6 months. Sanitary pad weight declined from an average of 35.45 g per day at baseline to 12.47 g at the 3rd treatment, and increased to 23.06 g at 12 months. Vaginal acidity changes showed a similar pattern. No serious adverse events were reported. Pixel-CO2 laser is safe and effective for treating SUI. Additional maintenance treatments should be considered during the 6–12-month post-treatment period in order to maintain the beneficial effects. Brief summary Pixel-CO2 laser is a safe and effective treatment for SUI. Maintenance treatments should be considered at 6–12 months.

The evidence behind the use of LASER for genitourinary syndrome of menopause, vulvovaginal atrophy, urinary incontinence and lichen sclerosus: A state‐of‐the‐art review

“…A total of 114 papers were included according to the eligibility criteria listed above. Of these, 111 studies investigated GSM, VVA, UI, and LS symptoms as primary indication (Tables 3–6); 15 RCT, 23–37 87 cohort studies, 38–124 eight case reports, 125–132 one case‐control study, 133 including a total of 9000 women, not accounting for overlap between the studies. Additionally, three cross‐sectional studies focused solely on the characteristics of AEs 134–136 .…”

“…Of the included studies, 81 studies investigated CO 2 ‐LASER from different manufacturers 23–31,33,35,36,38–58,66–93,95–104,122–125,128–131,133,136 . Twenty‐eight studies investigated Er:YAG LASER from different manufacturers 32,34,59–65,94,107–121,127,132,135 .…”

“…Thirty studies on the effect of vaginal LASER on UI were identified through this review (Table 5). 33,34,95–121,127 The studies include 2053 women with study sizes ranging from 1 to 327 women with a median (IQR) of 46 (31.5–72.75) women. Of these studies, 17 studies investigated the effect of Er:YAG, 34,107–121,127 and 11 studies the effect of CO 2 LASER 33,95–104 .…”

“… 33,34,95–121,127 The studies include 2053 women with study sizes ranging from 1 to 327 women with a median (IQR) of 46 (31.5–72.75) women. Of these studies, 17 studies investigated the effect of Er:YAG, 34,107–121,127 and 11 studies the effect of CO 2 LASER 33,95–104 . We identified two RCTs including 186 women, 33,34 27 cohort studies including 1866 women 95–121 and one case‐report with one woman 127 …”

“…Of these studies, 17 studies investigated the effect of Er:YAG, 34,107–121,127 and 11 studies the effect of CO 2 LASER 33,95–104 . We identified two RCTs including 186 women, 33,34 27 cohort studies including 1866 women 95–121 and one case‐report with one woman 127 …”