Stress urinary incontinence (SUI) is a common cause of urinary incontinence affecting a large number of women and significantly influencing their quality of life. In the last decade, vaginal Er:YAG laser therapy was introduced as a minimally invasive treatment option for SUI.
The purpose of this study was to evaluate the long-term efficacy and safety of erbium laser treatment for female stress urinary incontinence (SUI).
In this single-center prospective study covering the period from April 2014 to January 2016, we performed non-ablative Er:YAG laser thermal therapy on 132 female patients suffering from stress urinary incontinence. The patients received two laser sessions with a 4-6 week interval. Follow-ups were performed at 3 and 18 months. For assessment of stress urinary incontinence, ICIQ-UI SF and ISI by Klovning questionnaires were used. Patient satisfaction was measured using an 11-point numerical scale. Long-term follow-ups were performed via telephone interviews, at which an additional questionnaire was used to assess the duration of SUI improvement and the patient’s willingness to repeat the treatment. Adverse events were registered at each follow-up.
132 patients with SUI were included in this study. The average age was 50.3 years (range 23-75) and average parity 1.9 (range 0-4). Average ICIQ-UI SF score at baseline was 12.3, which decreased to 5.19 at the 3-month follow-up (improvement of 7.1 points). At the 3-month follow-up, 19% of the patients were dry and 96.8% had improved ICIQ-UI SF scores. 75% of the patients had the full effect lasting at least 12 months and 24% for at least 18 months. The average duration of improvement was 12.0 months. 85% of the patients were not disappointed when the symptoms started to come back and 97% were satisfied with the treatment (average score at 18 months was 7.9/10; 67% with grades 8-10). 98% of the patients would repeat the therapy. All reported adverse effects were mild and transient.
Erbium laser treatment showed efficacy in the improvement of female SUI with no major adverse effects noted. Patient discomfort during the treatment was minimal and satisfaction was very high.
Key words: Stress urinary incontinence, vaginal Er:YAG laser therapy, long-term efficacy.
