Non-ablative Er Research Articles

A novel objective evaluation method, shear wave elastography, in the treatment of atrophic vaginitis by nonablative intravaginal Er:YAG laser, a randomized-sham controlled pilot study.

The aim of the study was to investigate the effectiveness of intravaginal Er:YAG laser for treating atrophic vaginitis in postmenopausal women utilizing shear wave elastography. In this prospective randomized sham-controlled double-blind pilot study, 20 participants were included (laser group [n = 12] / sham-control group [n = 8]). A nonablative (Smooth mode) Er:YAG laser with a wavelength of 2,940 nm was used. Objective evaluation of laser treatment efficacy was conducted using a special ultrasonic technique: shear wave elastography. Ultrasonic velocity measurements were taken from the anterior and posterior vaginal walls. Mean elasticity (E mean ) was expressed in kilopascals (kPa). Additional outcome parameters were vaginal pH, Vaginal Health Index (VHI), Female Sexual Function Index (FSFI), and visual analog scale (VAS) scores for dyspareunia. Baseline clinical characteristics, vaginal pH, VHI, VAS and FSFI scores, and E mean values were comparable between the laser and sham-control groups. Statistically significant differences were observed in the final E mean values of the anterior vaginal wall (13.1 ± 6.3 vs 20.0 ± 3.3 kPA, P = 0.01) and posterior vaginal wall (12.7 ± 10.3 vs 19.4 ± 6.9 kPA, P = 0.04) between the laser and sham-control group. Despite comparable baseline E mean values, significant differences in vaginal wall stiffness posttreatment indicated a notable increase in tissue elasticity following laser treatment. Statistically significant differences were also observed in final vaginal pH values, VHI, VAS scores, and FSFI score improvement in favor of laser treatment. Shear wave elastography may be considered as a reliable and objective technique for evaluating the efficacy of Er:YAG laser treatment in women with atrophic vaginitis. However, additional studies with larger sample sizes are necessary to establish conclusive evidence.

Safety and Efficacy of Erbium: Yttrium-Aluminum-Garnet Laser Treatment in Chinese Women with Mild-to-Moderate Stress Urinary Incontinence.

Background: This study aims to evaluate the safety and efficacy of erbium:yttrium-aluminum-garnet (Er:YAG) laser treatment in female patients with mild-to-moderate stress urinary incontinence (SUI). Methods: From July 2018 to June 2020, 72 female patients with mild-to-moderate SUI were enrolled in this study. A baseline assessment was conducted, which included a 1-hour pad test, the validated International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF), postvoid residual (PVR) testing, pelvic organ prolapse quantification (POP-Q) testing, and a cough stress test. All patients underwent four sessions of Er:YAG laser treatment using a smooth mode. A reassessment was performed 6 months after treatment to evaluate the safety and efficacy of the Er:YAG laser. Results: All patients completed four clinic visits, with a 1-month interval, and were followed up for a minimum of 6 months. No severe adverse reactions were observed during the treatment process. The 1-hour pad test revealed a significant reduction in urinary leakage from baseline (6.30 ± 1.06 g) to the 6-month follow-up (2.70 ± 0.96 g, p < 0.001), with 34 of 72 (47.22%) patients achieving negative results. The ICIQ-UI-SF score significantly decreased from baseline to 6 months (10.82 ± 1.38 to 2.96 ± 0.52, p < 0.001). PVR experimental results showed a significant decrease in residual urine volume after treatment (103.72 ± 8.61 mL to 43.86 ± 4.92 mL, p < 0.001). At the 6-month follow-up, hematoxylin and eosin staining results demonstrated that Er:YAG laser treatment significantly facilitated an increase in the thickness of squamous epithelial cells. The efficacy of Er:YAG laser treatment for SUI was 77.78% (56/72). Conclusions: Several objective and subjective assessments confirmed the safety and efficacy of vaginal smooth mode Er:YAG laser treatment for mild-to-moderate SUI during the 6-month follow-up period. Nonablative Er:YAG laser in the smooth mode is a viable treatment option for SUI patients.

Prospective study of safety and objective improvement in sysmptoms of GSM (Genitourinary syndrome of menopause) withEr:YAG vaginal /urethral laser treatment

: Genitourinary Syndrome of Menopause (GSM) is the condition which combines the conditions of vulvovaginal atrophy (VVA) and urinary tract dysfunction which are associated with oestrogen deficiency. GSM is treated using vaginal laser therapy by using non-ablative Er: YAG laser therapy to evaluate the effectiveness and safety of this therapy. The present study was planned to evaluate the safety and objective improvement in symptoms of GSM with Er:yag vaginal / urethral laser treatment in sextual and urinary symptoms of post / peri menopausal women on long term basis. A prospective study was conducted at V care laser centre from 2020 on words to till date. Total sample population enrolled was 74 among them 53 completed 1 follow up and 29 had completed 2 follow up. Data were collected before and subsequent 2 follow ups over next 12 months on parameters like dryness, dyspareunia, itching/ burning and lower urinary tract symptoms, data were collected using VLQ (vaginal laxity questionnaire), VHIS (vaginal health index score), FSDS-R (The female sexual distress scale – revised)and Satisfaction questionnaire (0-3) assessed on FSFI. : The study showed symptomatic improvement among patients with GSM like no pain or mild pain among 79.31% and 20.39% respectively, no itching (72.41%) at the end of 2 follow up. There was an improvement in vaginal condition (normal – 93.10%) at the end of 2 follow up. Majority of patients reported no sexual distress (82.7%). : The non-ablative Er: YAG laser therapy is efficacious and safe modality for treatment of symptoms in cases of genitourinary syndrome of menopause. It also offers a promising, minimally invasive safe treatment for SUI.

Erbium:Yttrium Aluminum Garnet (Er:YAG) Laser: A Minimally Invasive Treatment Method in Selected Patients with Impaired Breathing During Sleep-The Assessment of Treatment Effectiveness After 4 Years.

Objective: The aim of this study was to assess the long-term outcomes of nonablative Er:YAG laser treatment for snoring. Background data: Nonablative Er:YAG laser treatment has been shown to improve subjective quality of sleep without serious adverse effects, but long-term data are lacking. Materials and methods: Twenty-four patients with snoring problems due to soft palate hypertrophy were treated with three treatment procedures with Er:YAG laser performed at 2-week intervals. Subjective (questionnaires) and objective (polygraph) outcome measures were assessed at baseline, 3 months, and 4 years after the final laser treatment. Results: Twenty patients returned for the 4 years follow-up. The significant improvement in subjective sleep outcomes observed 3 months after Er:YAG laser treatment was still significant 4 years after treatment. No significant improvement or deterioration in objective polygraph outcome measures was observed during the 4 years of follow-up in our study. No side effects of laser treatment were observed. Conclusions: The Er:YAG laser treatment presents a safe and well-tolerated snoring treatment alternative for patients with airway obstruction in the oropharynx with improvement in subjective sleep outcomes lasting up to 4 years.

Non-ablative Er:YAG-laser treatment improves quality of life in menopausal female pattern hair loss

Female Pattern Hair Loss (FPHL) has emerged as the preferred term for androgenetic alopecia (AGA) in women. FPHL is the most common hair loss disorder in women. Among menopausal women, as many as two-thirds suffer from hair thinning or bald spots. They experience a greater impact than men because it's less socially acceptable. Menopausal women already experience a loss of confidence and low self-esteem. Alopecia can severely affect a woman's emotional well-being and quality of life, leading to psychological stress, depression and disrupted social relationships. Therefore, many women seek medical treatment.

Intraurethral ER:YAG laser for stres urinary incontinence

Purpose: To compare the efficacy of concomitant application of intraurethral (IU)+intravaginal (IV) non-ablative Er:YAG laser with IV application in improving the symptoms of stress urinary incontinence (SUI) in women.

Modern possibilities for the prevention of pelvic organ prolapse

In the practice of an obstetrician-gynecologist, the problem of pelvic organ prolapse is increasingly being raised. Symptoms of pelvic organ prolapse are noted from a young age, gradually progressing and reducing the patient’s quality of life. Various surgical methods of treatment also don’t solve the problem of prolapse. The recurrence rate after correction of prolapse with own tissues reaches 40%, and operations using mesh implants have a number of specific complications, the fight against which sometimes becomes more difficult than primary intervention. Despite the steady increase in the prevalence of the disease, effective methods of dealing with it have not yet been developed. Also, the tactics of managing patients at the initial stage of prolapse, when there are complaints, but they are not given enough attention, both by the doctor and the patient, are not defined. The main risk factors for the disease are: perineal ruptures during childbirth, episiotomy, menopause, repeated pregnancies and childbirth, polyhydramnios, multiple pregnancy, fetal macrosomia, conditions accompanied by a chronic increase in intraabdominal pressure, heavy physical labor, impaired innervation and circulation of the pelvic floor, genetic predisposition, hysterectomy and connective tissue dysplasia. The review is devoted to the causes and methods of prevention of pelvic organ prolapse at the present stage. Methods such as pelvic floor muscles training, including in the biofeedback mode using vaginal simulators, electrical impulse stimulation, high-intensity focused electromagnetic stimulation, and non-ablative Er:YAG laser therapy are considered. A systematic literature search was carried out using Scopus, web of Science, MedLine, PubMed and eLibrary data base system.

Non-ablative Er:YAG laser treatment for stress urinary incontinence (SUI)

To evaluate efficacy and safety of the FotonaSmooth device in treatment of SUI (stress urinary incontinence) patients after treating them with Er: YAG laser using both objective and patient-reported outcomes. Stress urinary incontinence (SUI) is a leakage of urine during moments of physical activity that increases abdominal pressure, such as coughing, sneezing, laughing, or exercise. It is most common seen health problem among women of certain age and it is most common type of urinary incontinence in women. Here, SUI is treated using intravaginal laser therapy by using non ablative Er: YAG (erbium-doped yttrium aluminium garnet) laser with SMOOTH mode technology.: The 96 parous women with SUI were treated according to IncontiLaseclinical treatmentprotocol by using non-ablative Er: YAG (erbium-doped yttrium aluminium garnet) laser with SMOOTH mode technology at Vcare laser centre state of art centre for cosmetic gynaecology, Indore, Madhya Pradesh. At baseline, at 2 months and at 9 months after treatment patients were clinically examined, answered questionnaires for SUI severity and sexual function assessment. King‘s Health Questionnaire (KHQ); UDI-6 (Urogenital Distress Inventory, Short Form) Questionnaire; 3D Voiding Diary ;Satisfaction Questionnaire (0-3) which was used for assessment of relief of symptoms (complaints) and satisfaction. Patients were monitored for side-effects and discomfort during treatment period and follow-up period.A total of 96 patients suffering from mild-to-moderate stress urinary incontinence underwent treatment with an Er:YAG (2940 nm) laser in non-ablative fractional mode, which requires 2-3 sessions with one month interval (Out of 96 patients- 96 patients completed the first session; 72 patients completed two sessions and 30 patients completed three sessions). Out of which 75% patients were very satisfied with the treatment and outcome. The Enrolment of study participants was started in September 2017 and completed in April 2019.The non-ablative Er: YAG laser therapy improves the impact of SUI symptoms in parous women significantly better than placebo by improving the quality of life and sexual function; it also provides a promising minimally invasive safe treatment for stress urinary incontinence (SUI) confirmed by the preliminary results.

Vaginal non-ablative Er:YAG laser sexual dysfunction therapy in women with interstitial cystitis/bladder pain syndrome: A Case Series

ABSTRACT Introduction Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic debilitating disease characterized by urinary frequency, urgency, and pelvic pain. Different studies have evaluated sexual well-being and e female sexual dysfunction (FSD) in IC/BPS patients. FSD in women with IC/BPS consists of dyspareunia, altered sexual desire, reduced orgasm frequency and vaginal insufficient lubrication. Recently, it has been repeatedly demonstrated that vaginal non-ablative erbium YAG laser (VEL) therapy can improve objective and subjective symptoms in different conditions. In our experience, VEL was very effective in various indications (stress urinary incontinence, mixed urinary incontinence, overactive bladder, genitourinary syndrome of menopause and FSD). In this study we evaluated the effects of VEL on FSD in women suffering from IC/BPS. Materials and methods This is case series study in which women with IC/BPS were also reporting FSD. The patients were treated with VEL with protocol in which the laser firstly irradiated the whole anterior vaginal wall and then also the entire vaginal canal. Local topical anesthesia was applied to the vagina before the laser irradiation. The therapy consisted in 1 treatment every 30 days, for 3 months. For the assessment of treatment effects we evaluated the personal history including: age at onset of IC/BPS and FSD, type of IC/BPS, bladder IC/BPS surgeries, the numeric rating scale-11 (NRS-11), O'Leary-Sant interstitial cystitis symptom and problem indexes (ICSI and ICPI), functional bladder capacity, daily urinary frequency, female sexual function index (FSFI) and vaginal health index score (VHIS). Follow-up was done 6 months from the first laser session. Potential adverse effects were observed at every visit as well as at 6 months follow-up. Results Six women were treated with the three sessions of VEL and followed for 6 months. The FSFI and VHIS significantly improved in all patients. The NRS-11 scores and the part of pain question of ICSI and ICPI improved as well. The bladder capacity and daily urinary frequency showed a marginal improvement. The therapy effects lasted for 6 months from the first treatment. All observed adverse effects were mild and transient. Conclusion Women suffering from IC/BPS have often impaired sexual life. Our data suggest that, besides being safe, VEL treatment can improve sexual life reducing also pain symptoms in IC/BPS patients. Further larger studies are needed in order to ascertain the relations between vaginal conditions and bladder pain, evaluating the possible role of VEL as a new approach for the treatment of FSD in IC/BPS women. Disclosure Work supported by industry: no.

Non-ablative Er:YAG laser is an effective tool in the treatment arsenal of androgenetic alopecia.

BackgroundUp to 70% of the adult population worldwide is affected by androgenetic alopecia (AGA) hair loss. Laser therapy offers an addition or alternative to pharmaceutical and surgical treatment of hair regrowth, with non‐ablative lasers being preferred over ablative lasers in terms of safety and downtime. Combining laser therapy with different topical agents may result in better hair regrowth.ObjectiveThe aim was to evaluate the effectiveness and safety of non‐ablative Er:YAG laser used in clinical practice, alone or in combination with other treatment modalities, in patients with both early and advanced stages of AGA.Methods and patientsSixteen patients (7 male and 9 female) with active AGA in different stages were treated with the non‐ablative Er:YAG laser (SMOOTHTM mode, 7 mm spot size, 7.00 J/cm2 pulse fluence, 3.3 Hz frequency) as a monotherapy or in combination with injections of platelet‐rich plasma (PRP) to the scalp, topical minoxidil, and oral supplements for the promotion and support of hair growth. Efficacy was assessed with clinical assessment of AGA grade (Ludwig scale for female / Norwood‐Hamilton scale for male) and with blind evaluation of hair quality in global photographs before and after treatment. Patients subjectively rated their satisfaction with the laser treatment on a scale from 0–3 and pain on a VAS scale from 0–10.ResultsAGA grade after treatment was lower compared to baseline (p = 0.015 and p = 0.125 in female and male patients, respectively). Blind evaluation indicated an improvement in hair quality in 93% of patients, either being described as much better (14%) or as better (79%), which was not correlated with age or AGA grade. The median satisfaction score was 3, and the median VAS score for pain was 2. The positive effect of the treatment on the hair quality is ongoing. No adverse reactions were reported.ConclusionsThe treatment was effective in treating AGA, confirmed by a decrease in AGA grade and by blinded evaluation of global photographs. Although the possible additive or complementary effect of topical minoxidil or nutraceuticals cannot be excluded, our results suggest that the non‐ablative Er:YAG laser SMOOTH™ mode as a monotherapy, or in combination with PRP, is an efficient and safe treatment for AGA—with a high satisfaction rate among patients regardless of patient age, AGA duration, or AGA stage.

Periocular rejuvenation using a unique non-ablative long-pulse 2940\xa0nm Er:YAG laser

The periocular region is challenging for cosmetic laser surgeons. Surgery and laser resurfacing have traditionally been used to correct periorbital lines and wrinkles. Although effective, the associated downtime with these methods has made many people reluctant to decide for such treatments. More recently, the non-ablative long-pulse 2940 nm Er:YAG laser is being used to improve the structure and function and hence the appearance of skin in the periorbital region. The objective of this study is to evaluate the safety and efficacy of long-pulse 2940 nm Er:YAG laser for non-ablative treatment of periorbital static wrinkles and skin laxity. This is a prospective analysis of 30 patients treated for periorbital rejuvenation using three sessions of non-ablative long-pulse Er:YAG laser over a 3-month period. All patients were assessed according to Fitzpatrick’s classification of periorbital wrinkles to class I, II, or III and were treated with 2940 nm Er:YAG laser using a fluence of 3.75 J/cm2, a repetition rate of 1.7–2 Hz, and with the SMOOTH™ pulse mode (250 ms). The treatment sessions were performed on each patient, 4 weeks apart. Patient improvement was assessed before each laser session as well as at 12 months after the final treatment. Blind photographic evaluations were performed by three independent physicians using unlabeled before and after photos arranged in non-chronological order. Reviewers were asked to determine the before and after photos. Patients were asked to answer a questionnaire measuring satisfaction 4 weeks after each session, and to report any adverse reactions. There was statistically and clinically significant improvement in the Fitzpatrick classification of the periorbital wrinkles. Blinded evaluators correctly identified the before and after photos in all cases. All patients reported mild edema and erythema, which persisted for 1 to 2 days, and superficial peeling of the skin for 4 to 6 days after each laser treatment. No long-term adverse effects were reported. The non-ablative long-pulse 2940 nm Er:YAG laser seems to be a safe and effective treatment for periocular rejuvenation with minimal and tolerable adverse reaction. The improvement attained from the laser sessions was persisting after 1 year denoting the long-term efficacy of the procedure.

Nonablative transurethral Erbium:YAG laser treatment for chronic prostatitis/chronic pelvic pain syndrome: A prospective comparative study.

AimsThis prospective study aimed to compare the clinical outcomes between the use of Erbium:YAG (Er:YAG) laser in a nonablative mode, to the use of the pharmacological treatment of oral tadalafil for the treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).MethodsThe laser group received two sessions of Erbium:YAG laser, administered intraurethrally in a long, nonablative train of long pulses (SMOOTH™ mode), applied at the level of the male prostatic urethra. Tadalafil group received oral tadalafil at a dose of 5 mg/day, consecutively for 2 months. Effectiveness was assessed using the International Prostate Symptom Score (IPSS) questionnaire, VAS (visual analogue scale) pain score, and maximum urethral flow at follow‐up visits up to 12 months after initiating treatment. Adverse effects were recorded after each treatment and follow‐up sessions.ResultsThe results show a significant decrease in the IPSS score in both groups up to the 12‐month follow‐up. The increase in Q‐max was evident up to 3‐months follow‐up in the tadalafil group and up to 6 months in the laser group. The decrease in the VAS pain score was also significant in both treatment groups, lasting up to 3 months in the tadalafil group and up to 6 months in the laser group.ConclusionsThe nonablative Er:YAG SMOOTH™ laser seems to be a promising treatment for this widely occurring condition. More studies are needed to confirm its safety and efficacy.

Deciphering the molecular effects of non-ablative Er:YAG laser treatment in an in vitro model of the non-keratinized mucous membrane

Deciphering the molecular effects of non-ablative Er:YAG laser treatment in an in vitro model of the non-keratinized mucous membrane

Effects of non-ablative Er:YAG laser on the skin and the vaginal wall: systematic review of the clinical and experimental literature.

Er:YAG laser is frequently used in dermatology and gynecology. Clinical studies document high satisfaction rates; however, hard data on the effects at the structural and molecular levels are limited. The aim of this systematic review was to summarize current knowledge about the objective effects of non-ablative Er:YAG laser on the skin and vaginal wall. We searched MEDLINE, Embase, Cochrane, and the Web of Science. Studies investigating objectively measured effects of non-ablative Er:YAG laser on the skin or vaginal wall were included. Studies of any design were included. Owing to the lack of methodological uniformity, no meta-analysis could be performed and therefore results are presented as a narrative review. We identified in vitro or ex vivo studies on human cells or tissues, studies in rats, and clinical studies. Most studies were on the skin (n = 11); the rest were on the vagina (n = 4). The quality of studies is limited and the settings of the laser were very diverse. Although the methods used were not comparable, there were demonstrable effects in all studies. Immediately after application the increase in superficial temperature, partial preservation of epithelium and subepithelial extracellular matrix coagulation were documented. Later, an increase in epithelial thickness, inflammatory response, fibroblast proliferation, an increase in the amount of collagen, and vascularization were described. Er:YAG laser energy may induce changes in the deeper skin or vaginal wall, without causing unwanted epithelial ablation. Laser energy initiates a process of cell activation, production of extracellular matrix, and tissue remodeling.

Er:YAG laser treatment of urinary incontinence after failed TOT/TVT procedures

ObjectiveTo determine if the Er:YAG laser can improve the symptoms of SUI patients after previously failed TOT/TVT procedures. Study DesignThis retrospective study includes the data of patients who were recruited from two different out-patient clinics of Obstetrics and Gynecology Department. 25 women with persistent SUI after failed TOT/TVT operations and 25 women who previously did not receive either any type of surgical treatment procedure or non-invasive treatment modalities for SUI. Er:YAG laser with 2940 nm was used in the treatment procedure for SUI setting. The patients were evaluated on the basis of ICIQ-SF before and after the procedure. The severity of SUI symptoms was graded. According to the differences in the ICIQ-SF between before and after the procedure, the percentage of improvement was graded as good responders (≥50 %) or poor responders (<50 %).The duration of the treatment effect was evaluated in follow-ups with relation to maximum improvement time (MIT) and total improvement time (TIT). ResultsThe SUI patients who previously had failed TOT/TVT operations, had significantly higher initial ICIQ-SF score (p = 0.013). Non-ablative Er:YAG laser treatment significantly and similarly improved the severity of SUI symptoms in both groups (p = 0.000 for failed TOT/TVT group and p = 0.001 for non-TOT/TVT group, respectively). The women who were good responders, were younger (p = 0.012) and had less number of years in menopause (p = 0.011). The effect of Er:YAG laser treatment lasted longer among the SUI women in the good responders group (p = 0.000 for MIT and p = 0.000 for TIT, respectively). ConclusionsNon-ablative Er:YAG smooth mode laser is an alternative choice of treatment for the SUI patients who previously had failed TOT/TVT procedures. Its effect lasts longer especially in younger and early postmenopausal women.

Treating Vaginal Laxity Using Nonablative Er:YAG Laser: A Retrospective Case Series of Patients From 2.5Years of Clinical Practice.

IntroductionVaginal laxity drastically impairs women's quality of life, suggesting there is a need for effective noninvasive treatments.AimThe aim was to retrospectively assess the effectiveness and safety of a nonablative Er:YAG IntimaLase laser procedure for vaginal laxity in patients treated in our clinical practice during a 2.5-year period.MethodsLaser treatment for vaginal laxity was performed using an intravaginal nonablative Er:YAG laser. Effectiveness was assessed using a Patient Satisfaction Questionnaire and also by independent evaluation of before and after treatment photographs of the patients' introitus. The safety and tolerability of the procedure was monitored in all patients.Main Outcome MeasureThe study showed an improvement of sexual gratification and improvement of vaginal tightness, as assessed by patients. The tightness of the introitus was also improved, as assessed by independent evaluators.ResultsAs assessed by the Patient Satisfaction Questionnaire, we show that 92.7% of patients experienced improvement of sexual gratification after IntimaLase laser treatment. The results of the visual evaluation of the grade of laxity improvement in the introitus area, when open introitus photos were evaluated, show that 69% (n = 20/29) of patients had an improvement of laxity. Nonablative Er:YAG treatment seems to be an effective and safe treatment for vaginal laxity. As it is a noninvasive procedure, it should be considered before any vaginoplasty surgery. The study included all the patients treated in clinical practice and observed very few adverse effects. The results were comparable with other published data. Because it is a retrospective study, there is a lack of a control group.ConclusionThe results have confirmed that patients suffering from vaginal laxity can be effectively treated using the nonablative Er:YAG IntimaLase procedure without adverse effects.Mitsuyuki M, Štok U, Hreljac I. Treating Vaginal Laxity Using Nonablative Er:YAG Laser: A Retrospective Case Series of Patients From 2.5 Years of Clinical Practice. Sex Med 2020;8:265–273.

Treatment of snoring disorder with a non-ablactive Er:YAG laser dual mode protocol. An interventional study.

BackgroundSnoring disorder is a common problem among world population. Treatment modalities may involve surgical and non-surgical procedures. As main objective we proposed to evaluate the efficacy of non-ablative Er:YAG laser in the treatment of snoring disorder. Material and MethodsWe performed an interventional study in 30 patients with snoring disorders. Three sessions were performed with Er:YAG laser 2940nm in long pulse mode (2J/cm2) and smooth mode (10-8J/cm2) in oropharynx region. We analyzed the efficacy of this protocol using questionnaires for snoring intensity, snoring related characteristics of quality of life (including the Epworth sleepness scale and OHIP-14), the satisfaction of the patients and existence of adverse effects comparing the results before and after the treatment using Wilcoxon Signed Rank test. ResultsThere was a 96.7% satisfaction rate after one month of treatment, and 96.4% after 6 months. A reduction of the severity of snoring from 8±1.9 before the treatment to 1.6±1.1 one month after treatment was observed (p<0.001). Decrease in mean values of Epworth sleepness scale (9.97±5.3 to 6.54±4.3) (p=0.002), and OHIP-14 score (10.9±6.2 to 5.9±5) (p<0.001) were also noted. A significant decrease in the Mallampatti and Friedman classification scores were observed (p=0.001 and p<0.001, respectively). No anesthesia was required, nor adverse effects were observed. ConclusionsNon-ablative Er:YAG laser treatment is a safe, painless, and can be an effective treatment option to reduce snoring and is well accepted by the patient. However, further controlled studies with longer follow-up are required. Key words:Er:YAG laser, snoring, sleep disorders, epworth sleepiness scale, OHIP-14.

Outcomes of Non-Invasive laser Therapy for Treatment of Female Stress Urinary Incontinence

Objective: Female stress urinary incontinence (SUI) is common lower urinary tract symptom. It affects the patient's quality of life. This study aimed to evaluate the therapeutic outcomes of non-ablative Er: YAG laser therapy SUI. Study design: This was a prospective non-randomized study for female patients with SUI who were referred to the Urology Department, Sohag University Hospital from March 2017 to June 2018. The study was approved from Sohag University ethics committee. Patients were treated by the clinical protocol for SUI with non-ablative 2940 nm Er: YAG laser. Patients were evaluated at the baseline and every 3 months for 1 year by Validated International Consultation on Incontinence Questionnaire – Urinary Incontinence Short Form (ICIQ-UI SF) Arabic version and the number of daily pads usage .Side effects of the treatment were also reported. Results: Our results included 32female patients. 20 patients (63 %) had SUI while 12 patients (37%) had mixed incontinence. the median duration of symptoms 3 years. with 17 patients (53%) had mild to moderate SUI. There was a significant reduction in the median of daily pads usage from a median of 3to one pad per day at one year with P value (˂ 0.0001). The median (ICIQ-UISF) improved from 12to 5.5at one year (pvalue

Non-ablative Er:YAG laser therapy effect on stress urinary incontinence related to quality of life and sexual function: A randomized controlled trial

ObjectiveStress urinary incontinence (SUI) is a common complaint in women after childbirth. It affects their quality of life and sexual satisfaction and is one of the major reasons for gynaecological surgery. There is a need for effective non-invasive treatment alternatives. The aim of this study was to evaluate the efficacy and safety of non-ablative Er:YAG laser therapy in the treatment of SUI and improvement of sexual gratification in parous women. Study design114 premenopausal parous women with SUI were randomized in two groups of 57 women; a laser intervention group and sham group. Both groups were treated according to the IncontiLase® clinical treatment protocol for SUI with non-ablative thermal-only Er:YAG laser, except that there was no energy output when treating the sham group. Patients were blinded to the allocation. At baseline and 3 months after treatment patients were clinically examined, answered questionnaires for SUI severity and sexual function assessment and their pelvic floor muscle (PFM) function was assessed with perineometry. Validated International Consultation on Incontinence Questionnaire – Urinary Incontinence Short Form (ICIQ-UI SF) was used as the primary outcome measure. The Pelvic Organ Prolapse Urinary Incontinence Sexual Questionnaire short form (PISQ-12) and The Female Sexual Function Index (FSFI) were used to assess the sexual function. Patients were monitored for discomfort and side-effects during treatment and follow-up period. Results3 months after treatment the ICIQ-UI SF (p < 0.001), PISQ-12 (p = 0.014) and FSFI (p = 0.025) scores were significantly more improved in the laser group than in the sham control group. All perineometry variables improved in the laser group after treatment; duration and maximum pressure had statistically significantly better improvement than the sham group, whereas average pressure did not. 21% of laser treated patients were dry (ICIQ-UI SF = 0) at follow up compared to only 4% of the sham control patients. No serious adverse effects were observed or reported. The treatment was well tolerated by patients. ConclusionsThe non-ablative Er:YAG laser therapy improves the impact of SUI symptoms on quality of life and sexual function in premenopausal parous women significantly better than placebo. It provides a promising minimally-invasive safe treatment alternative for SUI.

Treatment of female stress urinary incontinence with Erbium-YAG laser in non-ablative mode

ObjectiveTo evaluate the efficacy of laser photothermal therapy in a group of Chilean women with SUI. Material and methodsLongitudinal prospective study based on 42 women with mild-to-severe SUI, intervened with non ablative Er:YAG laser, between July 2014 and October 2015, in Santiago, Chile. The therapy efficacy was evaluated through the difference between every patient's scores obtained, before and after treatment, with the International Consultation on Incontinence Questionnaire – Urinary Incontinence Short Form (ICIQ-SF), at a confidence level of 95%. Also, the patient satisfaction with treatment was reported through an ordinal scale. ResultsICIQ-SF median score was 11 before treatment and 3 after 6 months, with a significant difference per patient (p<0.001). 78.6% (n=33) reported improvement and 38.1% (n=16), a complete healing of SUI at follow up. 66.7% (n=28) reported high satisfaction and 81.8% (n=27) of sexually active women, also reported improvement of sexual gratification. Only mild pain during the procedure was reported as adverse effect. ConclusionsBased on this short-term pilot study, non-ablative Er:YAG laser procedure seems to be a safe and efficacious alternative for patients with SUI. Further controlled studies will help to validate the use of non-ablative Er:YAG for treatment of SUI.