The Effect of Vaginal Er:YAG Laser Therapy on Pelvic Floor Symptoms in Women With Stress Urinary Incontinence: A Single‐Center Cohort Study

TL;DR

This study shows that vaginal Er:YAG laser therapy can improve bladder and sexual function in women with stress urinary incontinence, but the benefits for bowel and prolapse symptoms are minimal.

Contribution

The study provides new evidence on the effectiveness of Er:YAG laser therapy for specific pelvic floor symptoms in women with stress urinary incontinence.

Findings

Bladder and sexual function scores showed statistically significant and sustained improvements after Er:YAG laser therapy.

Improvements in bowel function and prolapse symptoms were below the minimal important difference, suggesting limited clinical relevance.

Women with mixed urinary incontinence experienced less improvement in sexual function after treatment.

Abstract

To examine the effect of vaginal erbium:yttrium‐aluminum‐garnet (Er:YAG) laser therapy on pelvic floor symptoms in women with stress urinary incontinence (SUI).

This was a prospective, single‐arm interventional study applying three Er:YAG laser treatments to patients with SUI. The German version of the validated Australian Pelvic Floor Questionnaire was used to quantify pelvic floor symptoms (bladder function, bowel function, sexual function, pelvic organ prolapse) over different time points (baseline, posttreatment, 3 months, and 6 months after treatment). Subgroups were compared to examine which factors influenced symptom development after the treatment.

A total of 50 women received three Er:YAG laser treatments and had their symptoms evaluated at all time points of the study. All symptom complex scores, especially bladder function and sexual function, showed statistically significant improvements lasting for the whole study period. However, score improvements of bowel function and prolapse symptoms were likely not clinically meaningful, as they were below the minimal important difference (MID) of this questionnaire. Moreover, sexual function scores improved less when women additionally had urgency symptoms (i.e., mixed urinary incontinence [MUI]; p = 0.036).

Vaginal Er:YAG laser therapy has the potential to improve pelvic floor symptoms linked to bladder function and sexual function in women with SUI. However, the positive effect on sexual function was lower if the women had MUI.

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