nach oben

Lasers in Medical Science

Erschienen in:

24.01.2022 | Original Article

Vaginal erbium laser for treatment of stress urinary incontinence: optimization of treatment regimen for a sustained long-term effect

verfasst von: Adrian Gaspar, Neža Koron, Joaquin Silva, Hugo Brandi

Erschienen in: Lasers in Medical Science | Ausgabe 4/2022

Einloggen, um Zugang zu erhalten

Abstract

Stress urinary incontinence (SUI) is a common health problem that affects roughly 35% of women in the reproductive period. A prospective uncontrolled study was conducted to assess the long-term efficacy and safety of a non-ablative Er:YAG laser treatment of SUI. Forty-three patients participated in the study. All women underwent three sessions of IncontiLase® procedure, and efficacy of laser treatment was assessed by 1-h pad test, 24-h pad test, 3-day voiding diary, and ICIQ-UI SF questionnaire at multiple follow-ups. Statistical analysis was performed using one-way repeated measures ANOVA. Patients were questioned about discomfort during treatment and any adverse events following the laser procedures. All outcome measures showed a significant change over a period of the entire clinical trial. Eighteen-month follow-up revealed a fading of the effect, which was alleviated by single-session maintenance treatments every 6 months. There were no serious adverse events reported during the study. All reported side effects were mild and transient. The application of non-ablative Er:YAG laser for SUI treatment significantly improves the SUI symptoms. High improvement rates and patient satisfaction can be maintained with single-session maintenance treatments performed every 6 months. Long-term safety profile of multiple non-ablative Er:YAG laser treatment is shown. NCT04348994, 16.04.2020, retrospectively registered.

Van Kerrebroeck PEV, ed. ICS Standards 2022. 2020th ed. ICS; 2022.

MacLennan AH, Taylor AW, Wilson DHD, Wilson DHD (2000) The prevalence of pelvic floor disorders and their relationship to gender, age, parity and mode of delivery. BJOG An Int J Obstet Gynaecol 107(12):1460–1470. https://doi.org/10.1111/j.1471-0528.2000.tb11669.xCrossRef

Holroyd-Leduc JM, Straus SE (2004) Management of urinary incontinence in women. JAMA 291(8):986. https://doi.org/10.1001/jama.291.8.986CrossRefPubMed

Rovner ES, Wein AJ. Treatment options for stress urinary incontinence. Rev Urol. 2004;6 Suppl 3(Table 1):S29–47. doi:https://doi.org/10.1002/nau

Dumoulin C, Hay-Smith EJC, Mac H-Séguin G (2014) Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane database Syst Rev 5(5):119. https://doi.org/10.1002/14651858.CD005654.pub3CrossRef

Shamout S, Campeau L (2017) Stress urinary incontinence in women: current and emerging therapeutic options. Can Urol Assoc J 11(6):S155–S158. https://doi.org/10.5489/cuaj.4613CrossRefPubMedPubMedCentral

Chapple CR, Raz S, Brubaker L, Zimmern PE (2013) Mesh sling in an era of uncertainty: lessons learned and the way forward. Eur Urol 64(4):525–529. https://doi.org/10.1016/j.eururo.2013.06.045CrossRefPubMed

Nilsson CG (2015) Creating a gold standard surgical procedure: the development and implementation of TVT. Int Urogynecol J Pelvic Floor Dysfunct 26(4):467–469. https://doi.org/10.1007/s00192-014-2616-2CrossRef

El-Domyati M, Abd-El-Raheem T, Medhat W, Abdel-Wahab H, Anwer M Al. Multiple fractional erbium: yttrium–aluminum–garnet laser sessions for upper facial rejuvenation: clinical and histological implications and expectations. J Cosmet Dermatol. 2014;13(1):30–37. https://doi.org/10.1111/jocd.12079

10.

Vizintin Z, Rivera M, Fistonić I et al (2012) Novel minimally invasive VSP Er:YAG laser treatments in gynecology. J Laser Heal Acad 2012(1):46–58

11.

Lapii GAA, Yakovleva AYY, Neimark AII (2017) Structural reorganization of the vaginal mucosa in stress urinary incontinence under conditions of Er:YAG laser treatment. Bull Exp Biol Med 162(4):510–514. https://doi.org/10.1007/s10517-017-3650-0CrossRefPubMed

12.

Rechberger T, Postawski K, Jakowicki JA, Gunja-Smith Z, Woessner JF Jr (2016) Role of fascial collagen in stress urinary incontinence. Am J Obstet Gynecol 179(6):1511–1514. https://doi.org/10.1016/S0002-9378(98)70017-1CrossRef

13.

Lin KL, Chou SH, Long CY. Effect of er:yag laser for women with stress urinary incontinence. Biomed Res Int. 2019;2019. doi:https://doi.org/10.1155/2019/7915813

14.

Majaron B, Kelly KM, Park HB, Verkruysse W, Nelson JS (2001) Er:YAG laser skin resurfacing using repetitive long-pulse exposure and cryogen spray cooling: I. Histological study. Lasers Surg Med. 28(2):121–130. https://doi.org/10.1002/lsm.1026CrossRefPubMed

15.

Drnovšek-Olup B, Beltram M, Pižem J et al (2004) Repetitive Er:YAG laser irradiation of human skin: a histological evaluation. Lasers Surg Med 35(2):146–151. https://doi.org/10.1002/lsm.20080CrossRefPubMed

16.

Lapii GA, Yakovleva AY, Neimark AI, Lushnikova EL (2017) Study of proliferative activity of vaginal epithelium in women with stress urinary incontinence treated by Er:YAG laser. Bull Exp Biol Med. 1–4. https://doi.org/10.1007/s10517-017-3784-0

17.

Ghoniem G, Stanford E, Kenton K et al (2008) Evaluation and outcome measures in the treatment of female urinary stress incontinence: International Urogynecological Association (IUGA) guidelines for research and clinical practice. Int Urogynecol J Pelvic Floor Dysfunct 19(1):5–33. https://doi.org/10.1007/s00192-007-0495-5CrossRefPubMed

18.

FDA. Guidance for Industry and Food and Drug Administration Staff: Clinical Investigations of Devices Indicated for the Treatment of Urinary Incontinence.; 2011. http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/ucm07. Accessed March 7, 2018.

19.

Blaganje M, Šćepanović D, Žgur L, Verdenik I, Pajk F, Lukanović A (2018) Non-ablative Er:YAG laser therapy effect on stress urinary incontinence related to quality of life and sexual function: a randomized controlled trial. Eur J Obstet Gynecol Reprod Biol 224:153–158. https://doi.org/10.1016/j.ejogrb.2018.03.038CrossRefPubMed

20.

Bizjak-Ogrinc U, Senčar S, Lenasi H et al (2015) Novel minimally invasive laser treatment of urinary incontinence in women. Lasers Surg Med 47(9):689–697. https://doi.org/10.1002/lsm.22416CrossRef

21.

Pardo JI, Solà VR, Morales AA (2016) Treatment of female stress urinary incontinence with Erbium-YAG laser in non-ablative mode. Eur J Obstet Gynecol Reprod Biol 204:1–4. https://doi.org/10.1016/j.ejogrb.2016.06.031CrossRefPubMed

22.

Tien YW, Hsiao SM, Lee CN, Lin HH (2017) Effects of laser procedure for female urodynamic stress incontinence on pad weight, urodynamics, and sexual function. Int Urogynecol J Pelvic Floor Dysfunct 28(3):469–476. https://doi.org/10.1007/s00192-016-3129-yCrossRef

23.

Fistonic N, Fistonic I, Lukanovic A, et al. First assessment of short-term efficacy of Er:YAG laser treatment on stress urinary incontinence in women: prospective cohort study. Climacteric. 2015;18 Suppl 1(sup1):37–42. doi:https://doi.org/10.3109/13697137.2015.1071126

24.

Fistonic N, Fistonic I, Gustek SF et al (2016) Minimally invasive, non-ablative Er:YAG laser treatment of stress urinary incontinence in women–a pilot study. Lasers Med Sci 31(4):635–643. https://doi.org/10.1007/s10103-016-1884-0CrossRefPubMedPubMedCentral

25.

Kuszka A, Gamper M, Walser C, Kociszewski J, Viereck V. Erbium:YAG laser treatment of female stress urinary incontinence: midterm data. Int Urogynecol J. December 2019. https://doi.org/10.1007/s00192-019-04148-9

26.

Gaviria JP, Korosec B, Fernandez J et al (2016) Up to 3-year follow-up of patients with vaginal relaxation syndrome participating in laser vaginal tightening. J Laser Heal Acad 2016(May):1–6

27.

González Isaza P, Jaguszewska K, Cardona JL, Lukaszuk M. Long-term effect of thermoablative fractional CO2 laser treatment as a novel approach to urinary incontinence management in women with genitourinary syndrome of menopause. Int Urogynecol J. May 2017. https://doi.org/10.1007/s00192-017-3352-1

28.

Hardy LA, Chang C-H, Myers EM, Kennelly MJ, Fried NM. Laser treatment of female stress urinary incontinence: optical, thermal, and tissue damage simulations. In: Choi B, Kollias N, Zeng H, et al., eds.; 2016:96891R. https://doi.org/10.1117/12.2208126

29.

Karcher C, Sadick N (2016) Vaginal rejuvenation using energy-based devices. Int J Women’s Dermatology 2(3):85–88. https://doi.org/10.1016/j.ijwd.2016.05.003CrossRef

30.

Okui N (2019) Comparison between erbium-doped yttrium aluminum garnet laser therapy and sling procedures in the treatment of stress and mixed urinary incontinence. World J Urol 37(5):885–889. https://doi.org/10.1007/s00345-018-2445-xCrossRefPubMed

31.

FDA warns against use of energy-based devices to perform vaginal “rejuvenation” or vaginal cosmetic procedures: FDA Safety Communication | FDA. https://www.fda.gov/medical-devices/safety-communications/fda-warns-against-use-energy-based-devices-perform-vaginal-rejuvenation-or-vaginal-cosmetic. Published 2018. Accessed December 13, 2019.

32.

Gambacciani M, Cervigni M, Gaspar A et al (2020) Safety of Vaginal Erbium Laser (VEL^TM): a review of 113,000 patients treated in the past eight years. Climacteric 23(sup1):S28–S32. https://doi.org/10.1080/13697137.2020.1813098CrossRefPubMed

Titel: Vaginal erbium laser for treatment of stress urinary incontinence: optimization of treatment regimen for a sustained long-term effect
verfasst von: Adrian Gaspar
Neža Koron
Joaquin Silva
Hugo Brandi
Publikationsdatum: 24.01.2022
Verlag: Springer London
Erschienen in: Lasers in Medical Science / Ausgabe 4/2022
Print ISSN: 0268-8921
Elektronische ISSN: 1435-604X
DOI: https://doi.org/10.1007/s10103-021-03474-z

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Vaginal erbium laser for treatment of stress urinary incontinence: optimization of treatment regimen for a sustained long-term effect

Abstract

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 4/2022

The Er:YAG vaginal laser for management of women with genitourinary syndrome of menopause (GSM)

Systematic review and meta-analysis of randomized clinical trials comparing efficacy, safety, and satisfaction between ablative and non-ablative lasers in facial and hand rejuvenation/resurfacing

Clinical and radiographic effectiveness of mineral trioxide aggregate (MTA) partial pulpotomy with low power or high power diode laser irradiation in deciduous molars: a randomized clinical trial

Treatment of carpal tunnel syndrome by low-level laser therapy versus corticosteroid injection: a randomized, prospective clinical study

Use of photodynamic therapy and photobiomodulation as alternatives for microbial control on clinical and subclinical mastitis in sheep

In vivo efficacy of low-level laser therapy on bone regeneration