Abstract
PurposeStress urinary incontinence (SUI) and mixed urinary incontinence (MUI) lead to poor quality of life. In Japan, urinary incontinence is treated with tension-free vaginal tape (TVT) or transobturator tape (TOT) sling procedures, which involves inserting a synthetic material; however, problems arise with artificial mesh in some instances, requiring new treatment methods. Hence, laser therapy, whereby an erbium-doped yttrium aluminum garnet laser is directed into the vagina and urethra, may be useful. The study aimed to compare the effects of these three treatments.MethodsSubjects included patients who received TVT, TOT, or laser therapy (n = 50 each). The 1-h pad test, International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), and overactive bladder symptom score were used to assess the patients before and 12 months after treatment. For laser therapy, a probe was inserted into the vagina after applying a local anesthetic to the vaginal wall, and irradiation was performed for 20 min at a wavelength of 2940 nm. This treatment was performed three times every alternate month.ResultsAs per the 1-h pad test and ICIQ-SF, the TVT, TOT, and laser therapy groups showed comparable improvements in SUI. For patients with MUI, some in the TVT and TOT groups showed exacerbation; however, all patients in the laser therapy group tended to improve.ConclusionsThe efficacy of laser therapy for urinary incontinence was confirmed. This is the first study to report on the effect of laser therapy on urinary incontinence in Japanese women.
Highlights
Stress urinary incontinence (SUI) is a condition, wherein increased abdominal pressure, such as that from coughing, causes urinary leakage [1]; it affects up to 49% of all women
Attention has been drawn toward non-ablative erbium-doped yttrium aluminum garnet (Er:YAG) laser therapy, which consists of transvaginal laser irradiation of the urethra [8]
There are no global standards for Mixed urinary incontinence (MUI); overactive bladder symptom score (OABSS) was used, which is generally used as an indicator of urinary urgency and urge incontinence
Summary
Stress urinary incontinence (SUI) is a condition, wherein increased abdominal pressure, such as that from coughing, causes urinary leakage [1]; it affects up to 49% of all women. Mixed urinary incontinence (MUI) affects up to 29% of all women [2] and is a combination of SUI and urge incontinence, in which a strong urge to urinate is accompanied by urinary leakage. Among various surgical techniques for SUI, sling procedure is effective [1]. In studies on Caucasian women, an improvement in SUI was observed, and most subjects exhibited no adverse effects [10].
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