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

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Abstract

Introduction and hypothesis

Conservative treatment is recommended as first-line therapy for stress urinary incontinence (SUI). We hypothesized that CO2 laser treatment would demonstrate safety and efficacy for women with SUI.

Methods

A prospective, open-label, cohort study of 33 women (mean age 43 years) referred from a continence clinic after urologist/urogynecologist assessment, with a verified stress urinary incontinence diagnosis based on urodynamic testing. The participants completed three outpatient treatments with laser therapy and were subsequently evaluated at 1, 3 and 6 months. The independent t and chi-square tests were used to assess changes in sanitary pad usage and SUI symptoms.

Results

Sanitary pad usage decreased from a median of 12 per day at baseline to 7 at 1–3 months post-treatment (P < 0.0001) and returned to 12 at 6 months post-treatment. Scores on the Urogenital Distress Inventory and the International Consultation of Incontinence Questionnaire decreased (improved) significantly at 1–3 months post-treatment: from 45 ± 2 and 16 ± 4, respectively, to 29.3 ± 14.7 and 8.15 ± 3.1, respectively (P < 0.0001). The scores returned to levels similar to baseline at 6 months after treatment. Participants reported mild and transient side effects, with significant improvement in quality of life.

Conclusions

Laser therapy can be an optional conservative treatment for women who seek minimally invasive non-surgical treatment for the management of SUI. No serious adverse effects were reported though the sample size was not large, a possible limitation of the study. Further large randomized control trials are needed to appraise the efficacy and safety of laser therapy for stress urinary incontinence and to demonstrate the ultimate utility of this modality.

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Author notes

  1. Hanin Dabaja and Roy Lauterbach contributed equally to this work.

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Rambam Health Care Campus, and Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel

    Hanin Dabaja, Roy Lauterbach, Emad Matanes & Lior Lowenstein

  2. Department of Neuro-Urology, Rambam Health Care Campus, and Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel

    Ilan Gruenwald

Authors
  1. Hanin Dabaja
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  2. Roy Lauterbach
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  3. Emad Matanes
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  4. Ilan Gruenwald
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  5. Lior Lowenstein
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Correspondence to Roy Lauterbach.

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Dabaja, H., Lauterbach, R., Matanes, E. et al. The safety and efficacy of CO2 laser in the treatment of stress urinary incontinence. Int Urogynecol J 31, 1691–1696 (2020). https://doi.org/10.1007/s00192-019-04204-4

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  • DOI: https://doi.org/10.1007/s00192-019-04204-4

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