Abstract
Background and Objective In this paper we are reporting about assessment of efficacy and safety of erbium laser photothermal therapy in a group of Asian women with SUI in comparison to TVT and TOT. Methods This was a prospective, single center study, based on Asian women with mild-to-severe SUI, intervened with non-ablative Er:YAG laser, open surgery TVT, or TOT between 2013 and 2016, in Yokosuka, Japan. Laser therapy was executed with a 2940 nm Er:YAG laser, operating in a special SMOOTH mode designed to increase temperature of the vaginal mucosa up to 60-65°C without ablation. Laser treatment was done under local anesthesia with 9% Lidocaine ointment. TVT and TOT surgeries were done under lumbar anesthesia. Efficacy was evaluated with 1 hour pad test and ICIQ-SF. Results 130 patients diagnosed with mild to severe SUI were included in this study. 40 of them received laser therapy, 45 TVT and 45 TOT. Results of laser group: ICIQ-SF median was 11.5 before and 2.5 at 3 months FU. At follow-up 78% reported improvement and 37% a complete healing of SUI. In pad test, the average changed from 33.7g to 2.0 g. Of 21 sexually active women, 18 (85.7%) reported improvement of sexual gratification. Only mild pain during the procedure was reported as AE. TVT results: ICIQ-SF went from 12.6 to 2.2 and pad test from 37.6 to 2.2. 61.1% improved sexual gratification. AE: 2 infections, 1 severe pain, 2 bleedings over 400ml. TOT results: ICIQ-SF went from 12.8 to 2.5 and pad test from 37.2 to 2.9. 59.0% improved sexual gratification. AE: 1 infection, 1 severe pain, 1 bleeding over 100 ml. Conclusions Non-ablative Er:YAG laser procedure seems to be a safe and efficacious alternative for patients with SUI with comparable short-term efficacy to TVT and TOT and with much less adverse effects.
