Abstract

You have accessJournal of UrologyCME1 Apr 2023PD14-01 FRACTIONAL CARBON DIOXIDE VAGINAL LASER FOR THE TREATMENT OF URINARY SYMPTOMS: 24 MONTHS RESULTS Nataljia Kovacevic, Bernadette Zwaans, Royal Oak, Mi, Ly Hoang Roberts, Evelyn Shea, Lisa Vergos, Danielle Tenney, Larry Sirls, Priya Padmanabhan, and Kenneth Peters Nataljia KovacevicNataljia Kovacevic More articles by this author , Bernadette ZwaansBernadette Zwaans More articles by this author , Royal OakRoyal Oak More articles by this author , Mi Mi More articles by this author , Ly Hoang RobertsLy Hoang Roberts More articles by this author , Evelyn SheaEvelyn Shea More articles by this author , Lisa VergosLisa Vergos More articles by this author , Danielle TenneyDanielle Tenney More articles by this author , Larry SirlsLarry Sirls More articles by this author , Priya PadmanabhanPriya Padmanabhan More articles by this author , and Kenneth PetersKenneth Peters More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003261.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Fractional carbon dioxide laser (fCO2) has been proposed to treat frequency, urgency, urge urinary incontinence (UUI), and stress urinary incontinence (SUI) in genitourinary symptoms of menopause (GSM). The laser’s thermal effects help collagen remodeling, thereby improving vaginal tissue integrity and urethral support. Our aim was to prospectively measure the effect of vaginal fCO2 laser therapy on SUI and overactive bladder (OAB) symptoms at 24 months. METHODS: Women over 18 years with urogenital symptoms were enrolled in an open-label prospective trial. Participants underwent 3 laser treatments, each 6 weeks apart. Patients were required to be off vaginal estrogen for 3 months prior to receiving any treatments. Patients were offered additional annual treatment sessions. Follow up consisted of 6, 12-, 18-, and 24-month visits during which various questionnaires were administered including the Incontinence-Quality of Life (I-QOL), Overactive Bladder Questionnaire short form (OABq-SF), and Questionnaire for Urinary Incontinence Diagnosis (QUID). A voiding diary was collected at baseline, 6-, 12-, and 24- month visits. ANOVA analysis was used to compare means at each time point. RESULTS: 100 patients were enrolled at time of analysis. Baseline urinary symptoms consisted of 44.8% of patients with SUI, 57.1% with UUI, and 75.4% with frequency. Significant reduction in SUI episodes was observed at 6, and 24 months (p=0.0135; Figure 1), and participants noted improvement on QUID-SUI at 6, 12, and 24 months (p<0.0001). Number of urge leaks did not significantly improve on voiding diary (=0.0512), but significant subjective improvement was noted for OAB/UUI based on QUID-UUI and OABq-SF symptom scores at each time point (p<0.0001; Figure 1). Mean Patient Global Impression of Improvement scores improved at each treatment and follow up visit, with 46.4% reporting significant symptom improvement by 24 months. Participants had improvement between baseline and 24 months in vulvar dryness (50.9% vs 25%) and vulvar pain (48% vs 13%). CONCLUSIONS: This represents the longest prospective follow-up of laser effects on GSM associated urinary symptoms. Significant subjective improvement was noted for SUI and OAB/UUI up to 24 months after treatment. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e412 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nataljia Kovacevic More articles by this author Bernadette Zwaans More articles by this author Royal Oak More articles by this author Mi More articles by this author Ly Hoang Roberts More articles by this author Evelyn Shea More articles by this author Lisa Vergos More articles by this author Danielle Tenney More articles by this author Larry Sirls More articles by this author Priya Padmanabhan More articles by this author Kenneth Peters More articles by this author Expand All Advertisement PDF downloadLoading ...

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