The safety and efficacy of CO2 laser in the treatment of stress urinary incontinence

Dabaja, Hanin; Lauterbach, Roy; Matanes, Emad; Gruenwald, Ilan; Löwenstein, Lior

doi:10.1007/s00192-019-04204-4

Cited by 14 publications

(36 citation statements)

References 35 publications

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“…Vaginal application of CO 2 laser has been recently introduced for medical conditions related to the vaginal epithelium. Most of the studies on vaginal CO 2 laser have been performed for various symptoms under the newly defined broad term “genitourinary syndrome of menopause” (GSM) [7–9] and very few have assessed the efficacy in patients with SUI [10–14]. The promising outcome of SUI treatment in these prospective studies was short term, namely 3–4 months [14], 6 months [13], or slightly longer [11,12].…”

Section: Introductionmentioning

confidence: 99%

“…Most of the studies on vaginal CO 2 laser have been performed for various symptoms under the newly defined broad term “genitourinary syndrome of menopause” (GSM) [7–9] and very few have assessed the efficacy in patients with SUI [10–14]. The promising outcome of SUI treatment in these prospective studies was short term, namely 3–4 months [14], 6 months [13], or slightly longer [11,12]. In addition, most of these studies lack well‐accepted objective outcome measures.…”

Section: Introductionmentioning

confidence: 99%

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Fractional‐Pixel CO₂ Laser Treatment in Patients With Urodynamic Stress Urinary Incontinence: 1‐Year Follow‐Up

et al. 2020

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Background and Objectives Vaginal pixelated low power and long pulses (LPLP) CO2 laser has been suggested as an optional treatment for stress urinary incontinence (SUI) with many studies reporting short‐term improvements. The objective of this study was to assess the 1‐year subjective and objective efficacy of vaginal CO2 laser in women with urodynamic SUI. Study Design/Materials and Methods This was a prospective multicenter study. Patients with confirmed urodynamic SUI graded as mild or moderate were included. We used three sessions of fractional pixelated CO2 laser for vaginal application and followed up the patients at 6 and 12 months. We used the following measures at follow‐up: 1‐hour pad test (ICS protocol), questionnaires including Pelvic Floor Distress Inventory 20 (PFDI‐20), Pelvic Floor Impact Questionnaire (PFIQ), Patient Global Impression of Improvement (PGI‐I), and a 3‐day urinary diary. The urodynamic assessment was repeated at 6 months. Results Fifty‐two patients with SUI had three laser treatments, of whom 48 completed a 6‐month follow‐up and 42 patients completed 12‐month follow‐up. No serious adverse events were recorded during the study period. A significant reduction on the 1‐hour pad test was found from baseline (6.3 ± 1.6 g) to the 12‐month follow‐up (3.7 ± 1.4 g, P < 0.05) was found. PGI‐I showed 75.0%, 61.9%, and 64.3% improvements at 3, 6, and 12 months, respectively. PFDI improved significantly and consistently from baseline until 12 months (37.2 ± 3.89 to 16.1 ± 3.7, P < 0.05). Similarly, PFIQ showed significant improvements from the first treatment up to 12 months. Urodynamic assessment at 6 months showed that 41.4% of patients had no stress incontinence. Conclusion The vaginal CO2 laser was found to be effective for mild‐to‐moderate SUI over a follow‐up period of 1 year, according to a variety of objective and subjective parameters. The wide range of parameters enables optimal patient consultation and subsequent treatment. Lasers Surg. Med. © 2020 Wiley Periodicals LLC

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Fractional‐Pixel CO₂ Laser Treatment in Patients With Urodynamic Stress Urinary Incontinence: 1‐Year Follow‐Up

et al. 2020

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“…Lin et al [26] included 31 women in the study; 21 were treated with Er:YAG and 10 women with CO 2 laser and both treatment protocols seemed to be useful for the improvement of SUI symptoms. Dabaja et al [13] studied 33 women and besides the ICIQ UI SF score, they also analyzed sanitary pad usage, which decreased from 12/day at the baseline to 7/day 1–3 months after treatment ( P < 0.0001), but returned to 12 pad/day 6 months after the treatment. The ICIQ scores improved significantly at 1–3 months after treatment and returned baseline levels at 6 months after the treatment.…”

Section: Discussionmentioning

confidence: 99%

“…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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“…There is a wide approach to the treatment of symptoms, often in a stepwise fashion, including lifestyle changes, bladder retraining and pelvic floor muscle rehabilitation, drug therapy, intra-vesical botulinum toxin injections or neuromodulation. Recently vaginal laser therapy has been proposed as an emerging minimal invasive effective treatment option for women with OAB [1][2][3][4][5][6].…”

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confidence: 99%

Vaginal laser for overactive bladder syndrome

2020

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Overactive bladder syndrome (OAB) is defined as urinary urgency, usually with urinary frequency and nocturia, with or without urge urinary incontinence. The prevalence of OAB in adult women ranges between 11% and 42%, is particularly common in elderly people, and can overlap with the genitourinary syndrome of menopause (GSM). There is a wide approach to the treatment of symptoms, often in a stepwise fashion, including lifestyle changes, bladder retraining and pelvic floor muscle rehabilitation, drug therapy, intra-vesical botulinum toxin injections or neuromodulation. Recently, vaginal laser therapy has been proposed as an emerging minimal invasive effective treatment option for women with OAB. We explore this further.

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The safety and efficacy of CO2 laser in the treatment of stress urinary incontinence

Cited by 14 publications

References 35 publications

Fractional‐Pixel CO₂ Laser Treatment in Patients With Urodynamic Stress Urinary Incontinence: 1‐Year Follow‐Up

Fractional‐Pixel CO₂ Laser Treatment in Patients With Urodynamic Stress Urinary Incontinence: 1‐Year Follow‐Up

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

Vaginal laser for overactive bladder syndrome

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The safety and efficacy of CO2 laser in the treatment of stress urinary incontinence

Cited by 14 publications

References 35 publications

Fractional‐Pixel CO2 Laser Treatment in Patients With Urodynamic Stress Urinary Incontinence: 1‐Year Follow‐Up

Fractional‐Pixel CO2 Laser Treatment in Patients With Urodynamic Stress Urinary Incontinence: 1‐Year Follow‐Up

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

Vaginal laser for overactive bladder syndrome

Contact Info

Product

Resources

About

Fractional‐Pixel CO₂ Laser Treatment in Patients With Urodynamic Stress Urinary Incontinence: 1‐Year Follow‐Up

Fractional‐Pixel CO₂ Laser Treatment in Patients With Urodynamic Stress Urinary Incontinence: 1‐Year Follow‐Up

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