Comparison between erbium-doped yttrium aluminum garnet laser therapy and sling procedures in the treatment of stress and mixed urinary incontinence

World J Urol. 2019 May;37(5):885-889. doi: 10.1007/s00345-018-2445-x. Epub 2018 Aug 16.

Abstract

Purpose: Stress 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.

Methods: Subjects 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.

Results: As 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.

Conclusions: The 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.

Keywords: International Consultation on Incontinence Questionnaire Short Form; Non-ablative erbium yttrium aluminum garnet laser; One-hour pad test; Overactive bladder symptom score; Tension-free vaginal tape; Transobturator tape.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Female
  • Humans
  • Laser Therapy / methods*
  • Lasers, Solid-State
  • Middle Aged
  • Suburethral Slings*
  • Urinary Incontinence, Stress / complications
  • Urinary Incontinence, Stress / surgery*
  • Urinary Incontinence, Urge / complications
  • Urinary Incontinence, Urge / surgery*
  • Urologic Surgical Procedures / methods*