TREATMENT OF FEMALE STRESS URINARY INCONTINENCE WITH VAGINAL ERBIUM LASER: SINGLE CENTRE EXPERIENCE OF LONG-TERM EFFICACY

Authors:
Simi Giovanna MD, ASL TOSCANA NORD OVEST, Lucca.
Bracco Gianluca MD, PHD, ASL TOSCANA NORD OVEST, Lucca.
Nanini Chiara MD, ASL TOSCANA NORD OVEST, Lucca.
Puccetti Simone MD, PHD, ASL TOSCANA NORD OVEST, Lucca.
Goglia Lorenzo, MD, ASL TOSCANA NORD OVEST, Lucca.

AIM OF THE STUDY: The aim of the study is to evaluate the long-term effectiveness of minimally invasive non ablative Er:YAG laser therapy for stress urinary incontinence. MATERIALS AND METHODS: We enrol patients affected by SUI undergoing to our Urogynecological centre in Lucca. Patient’s age varies from 34 to 80 years old. All subjects are treated with vaginal erbium laser (VEL). Follow up visits (clinical examination and ICIQ-UI SF) are performed 1, 3, 6, 12, 24 months after the last laser session.
RESULTS: Our results show a statistically significant improvement of SUI at the end of the treatment, persisting for 6 month after the procedure with a worsening during years. However, the severity degree achieved after 2 years is inferior as compared to the situation before VEL. Stratifying data on ICIQ-UI SF score at the beginning of consultation (mild, moderate, severe, very severe), this trend of benefit is particular evident in the moderate and severe groups so VEL therapy could be consider an alternative to surgery.Laser procedure is well tolerated and side effects are few and transient.
DISCUSSION: Our analyses show that VEL in non ablative way can reduce the symptoms of SUI both in patients with moderate or severe degree of disease. Due to this patients are highly satisfied with clinical benefit and the quality life obtained by the treatment even if only for avoiding surgical treatment.

 

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