Skip to main content

Advertisement

Log in

Effect evaluation and influencing factor analysis of vaginal carbon dioxide laser in the treatment of stress urinary incontinence

  • Original Article
  • Published:
Lasers in Medical Science Aims and scope Submit manuscript

    We’re sorry, something doesn't seem to be working properly.

    Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

Abstract

To evaluate the clinical efficacy of carbon dioxide laser in the treatment of female stress urinary incontinence and analyze the influencing factors. A total of 46 patients with stress urinary incontinence treated in the Affiliated Hospital of Nantong University from March 2021 to August 2022 were included through strict inclusion criteria and exclusion criteria. All patients were treated with transvaginal carbon dioxide laser therapy, and Patient Global Impression of Change (PGI-C) was used to evaluate patients’ subjective satisfaction after treatment. The efficacy was evaluated by patient’s subjective assessment of leakage, IngelmanSundberg scale, 1-h urine pad test, and international consultation on incontinence questionnaire short form (ICI-Q-SF) before and after treatment, and the adverse reactions after treatment were recorded. The treatment effect was divided into “significant effect group” and “no significant effect group” by subjective satisfaction and post-treatment-related scale evaluation. After laser treatment, patients’ subjective symptom improved, the volume of 1-h urine pad test was reduced, and the ICI-Q-SF score was decreased, and the differences were statistically significant (P < 0.05). There was no significant difference in IngelmanSundberg scale before and after treatment (P = 1.00). Multivariate logistic regression analysis showed that pad test volume was significantly correlated with treatment effect (P = 0.007). Transvaginal carbon dioxide laser is a safe and effective method for the treatment of mild to moderate stress urinary incontinence in females. The less severe the urinary leakage, the better the treatment effect.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Imamura M, Abrams P, Bain C et al (2010) Systematic review and economic modelling of the effectiveness and cost-effectiveness of non-surgical treatments for women with stress urinary incontinence. Health Technol Assess 14(40):1–188, iii–iv. https://doi.org/10.3310/hta14400

    Article  PubMed  Google Scholar 

  2. Committee U (2018) Conservative management of urinary incontinence. J Obstet Gynaecol Can 40(2):e119–e125

    Article  Google Scholar 

  3. Okeahialam NA, Dworzynski K, Jacklin P et al (2022) Prevention and non-surgical management of pelvic floor dysfunction: summary of NICE guidance. BMJ 376

  4. Palos CC, Maturana AP, Ghersel FR et al (2018) Prospective and randomized clinical trial comparing transobturator versus retropubic sling in terms of efficacy and safety. Int Urogynecol J 29(1):29–35

    Article  PubMed  Google Scholar 

  5. deTayrac R, Deffieux X, Droupy S et al (2004) A prospective randomized trial comparing tension-free vaginal tape and transobturator suburethral tape for surgical treatment of stress urinary incontinence. Am J Obstet Gynecol 190(3):602–608

    Article  PubMed  Google Scholar 

  6. Wein AJ (2005) ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence. J Urol 173(3):908–909

    PubMed  Google Scholar 

  7. Gynecological Pelvic Floor Group of the Obstetrics and Gynecology Branch of the Chinese Medical Association. Guidelines for the diagnosis and treatment of female stress urinary incontinence (2017). Chinese J Obstet Gynecol, 52(05):289-293

  8. Li FG, Maheux-Lacroix S, Deans R et al (2021) Effect of fractional carbon dioxide laser vs. sham treatment on symptom severity in women with postmenopausal vaginal symptoms: a randomized clinical trial. JAMA 326(14):1381–1389

    Article  PubMed  PubMed Central  Google Scholar 

  9. Gao L, Wen W, Wang Y et al (2022) Fractional carbon dioxide laser improves vaginal laxity via remodeling of vaginal tissues in Asian women. J Clin Med 11(17):5201

    Article  PubMed  PubMed Central  Google Scholar 

  10. Mothes AR, Runnebaum M, Runnebaum IB (2018) An innovative dual-phase protocol for pulsed ablative vaginal Erbium:YAG laser treatment of urogynecological symptoms. Eur J Obstet Gynecol Reprod Biol 229:167–171

    Article  PubMed  Google Scholar 

  11. Nalewczynska AA, Barwijuk M, Kolczewski P et al (2022) Pixel-CO2 laser for the treatment of stress urinary incontinence. Lasers Med Sci 37(2):1061–1067

    Article  PubMed  Google Scholar 

  12. Ruffolo AF, Casiraghi A, Marotta E et al (2021) Does the time of onset of urinary symptoms affect microablative fractional CO2 laser efficacy in postmenopausal women? Lasers Surg Med 53(7):953–959

    Article  PubMed  Google Scholar 

  13. Geisser ME, Clauw DJ, Strand V et al (2010) Contributions of change in clinical status parameters to Patient Global Impression of Change (PGIC) scores among persons with fibromyalgia treated with milnacipran. Pain 149(2):373–378

    Article  PubMed  Google Scholar 

  14. Schüssler B, Alloussi S (1983) Ingelman-Sundberg classification of stress incontinence. Gynakologische Rundschau 23(3):166

    Article  PubMed  Google Scholar 

  15. Palacios S, Ramirez M (2020) Efficacy of the use of fractional CO2RE intima laser treatment in stress and mixed urinary incontinence. Eur J Obstet Gynecol Reprod Biol 244:95–100

    Article  PubMed  Google Scholar 

  16. ElSheemy MS, Fathy H, Hussein HA et al (2015) Surgeon-tailored polypropylene mesh as a tension-free vaginal tape-obturator versus original TVT-O for the treatment of female stress urinary incontinence: a long-term comparative study. Int Urogynecol J 26(10):1533–1540

    Article  PubMed  Google Scholar 

  17. Abdel-Fattah M, Ramsay I, Pringle S et al (2011) Evaluation of transobturator tension-free vaginal tapes in management of women with recurrent stress urinary incontinence. Urology 77(5):1070–1075

    Article  PubMed  Google Scholar 

  18. Dietz HP, Hansell NK, Grace ME et al (2005) Bladder neck mobility is a heritable trait. BJOG 112(3):334–339

    Article  CAS  PubMed  Google Scholar 

  19. Ashton-Miller JA, Howard D, DeLancey JO (2001) The functional anatomy of the female pelvic floor and stress continence control system. Scand J Urol Nephrol Suppl 207:1–7

    Google Scholar 

  20. Turkoglu A, Coskun ADE, Arinkan SA et al (2022) The role of transperineal ultrasound in the evaluation of stress urinary incontinence cases. Int Braz J Urol 48(1):70–77

    Article  PubMed  Google Scholar 

  21. Chen HY, Huang YL, Hung YC et al (2006) Evaluation of stress urinary incontinence by computer-aided vector-based perineal ultrasound. Acta Obstet Gynecol Scand 85(10):1259–1264

    Article  PubMed  Google Scholar 

  22. Xiao T, Chen Y, Gan Y et al (2019) Can stress urinary incontinence be predicted by ultrasound? AJR Am J Roentgenol 213(5):1163–1169

    Article  PubMed  Google Scholar 

  23. González Isaza P, Jaguszewska K, Cardona JL et al (2018) 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 29(2):211–215

    Article  PubMed  Google Scholar 

  24. Gaspar A, Brandi H, Gomez V et al (2017) Efficacy of Erbium:YAG laser treatment compared to topical estriol treatment for symptoms of genitourinary syndrome of menopause. Lasers Surg Med 49(2):160–168

  25. Salvatore S, Leone Roberti Maggiore U et al (2015) Histological study on the effects of microablative fractional CO2 laser on atrophic vaginal tissue: an ex vivo study. Menopause 22(8):845–849

    Article  PubMed  Google Scholar 

  26. Zhang L, Lai Y, Pan W et al (2021) Application of ultra pulse CO2 lattice laser in the treatment of female urinary incontinence. Transl Androl Urol 10(6):2471–2477

    Article  PubMed  PubMed Central  Google Scholar 

  27. Dabaja H, Lauterbach R, Matanes E, Gruenwald I, Lowenstein L (2020) The safety and efficacy of CO2 laser in the treatment of stress urinary incontinence. Int Urogynecol J 31(8):1691–1696

    Article  PubMed  Google Scholar 

  28. Lauterbach R, Aharoni S, Justman N et al (2022) The efficacy and safety of a single maintenance laser treatment for stress urinary incontinence: a double-blinded randomized controlled trial. Int Urogynecol J 23:1–6

    Google Scholar 

  29. Mortensen OE, Christensen SE, Løkkegaard E (2022) 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. Acta Obstet Gynecol Scand 101(6):657–692

    Article  PubMed  PubMed Central  Google Scholar 

  30. Alexander JW, Karjalainen P, Ow LL et al (2022) CO2 surgical laser for treatment of stress urinary incontinence in women: a randomized controlled trial. Am J Obstet Gynecol 227(3):473.e1–473.e12

    Article  CAS  PubMed  Google Scholar 

  31. Fistonić I, Fistonić N (2018) Baseline ICIQ-UI score, body mass index, age, average birth weight, and perineometry duration as promising predictors of the short-term efficacy of Er:YAG laser treatment in stress urinary incontinent women: a prospective cohort study. Lasers Surg Med

  32. Erel CT, Inan D, Mut A (2020) Predictive factors for the efficacy of Er:YAG laser treatment of urinary incontinence. Maturitas 132:1–6

  33. Ogrinc UB, Sencar S, Lenasi H (2015) Novel minimally invasive laser treatment of urinary incontinence in women. Laser Surg Med 47:689–697

    Article  Google Scholar 

  34. Ying T, Li Q, Xu L et al (2012) Three-dimensional ultrasound appearance of pelvic floor in nulliparous women and pelvic organ prolapse women. Int J Med Sci 9(10):894–900

    Article  PubMed  PubMed Central  Google Scholar 

  35. Al-Saadi WI (2016) Transperineal ultrasonography in stress urinary incontinence: the significance of urethral rotation angles. Arab J Urol 14(1):66–71

    Article  PubMed  Google Scholar 

  36. Sendag F, Vidinli H, Kazandi M et al (2003) Role of perineal sonography in the evaluation of patients with stress urinary incontinence. Aust N Z J Obstet Gynaecol 43(1):54–57

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yu-Quan Zhang.

Ethics declarations

Ethics approval

Approved by Ethics Committee of Affiliated Hospital of Nantong University

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wang, Y., Ye, Q. & Zhang, YQ. Effect evaluation and influencing factor analysis of vaginal carbon dioxide laser in the treatment of stress urinary incontinence. Lasers Med Sci 38, 153 (2023). https://doi.org/10.1007/s10103-023-03776-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s10103-023-03776-4

Keywords

Navigation