Effect of vaginal energy-based treatment on female stress urinary incontinence: a systematic review and meta-analysis of randomized controlled trials.

Abstract

To evaluate the efficacy and safety of vaginal energy-based therapies in treating female SUI. The PubMed, EMBASE, Web of Science, and Scopus databases were searched up to September 2022 to identify RCTs comparing energy-based therapies with placebo intervention in treating female SUI. The primary outcome was International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) score. Secondary outcomes included the 1-h pad test and cure rate. A total of 577 patients from 6 studies were included in the meta-analysis. Energy-based therapies did not significantly improve the ICIQ-SF score at all visits (≤ 1month: SMD, -0.39; 95% CI -0.80 to 0.03; P = 0.07; 3months: SMD, -1.32; 95% CI -4.07 to 1.43; P = 0.35; 6months: SMD, -0.39; 95% CI -0.91 to 0.12; P = 0.14). The subgroup analysis showed that there was no significant improvement in ICIQ-SF score in the CO2 laser group compared to the placebo group at all visits (≤ 1month: SMD, -0.13; 95% CI -0.59 to 0.34; P = 0.59; 3months: SMD, -1.50; 95% CI -3.91 to 0.92; P = 0.22; 6months: SMD, 0.13; 95% CI -0.47 to 0.72; P = 0.67). Meta-analysis was not performed in Er: YAG laser and radiofrequency therapy due to insufficient trials. Based on the limited clinical evidence, our meta-analysis showed no prior efficacy of energy-based therapy over placebo intervention. However, the results of this meta-analysis should be taken with caution due to the limited amount of available evidence and the heterogeneity among the included studies. CRD42022360471.