Laser therapy for stress urinary incontinence in women: a systematic review and meta-analysis

Authors

  • Fatimah Hussain Alkhamis Department of Obstetrics and Gynecology, King Faisal University, Alhasa, Saudi Arabia

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20250635

Keywords:

Urinary incontinence, Stress incontinence, Laser therapy, Meta-analysis, Systematic review

Abstract

Stress urinary incontinence (SUI) is a prevalent condition among women, significantly impacting their quality of life. Laser therapy has emerged as a non-invasive treatment option, but its efficacy remains uncertain due to limited evidence. This systematic review and meta-analysis aimed to evaluate the effectiveness of laser therapy in improving SUI symptoms, measured by changes in international consultation on incontinence questionnaire-urinary incontinence short form (ICIQ-UI SF) scores. A comprehensive search was conducted across PubMed, Web of Science, Scopus, Medline, the Cochrane Library, and Google Scholar, yielding 532 records. Six studies, including three randomized controlled trials and three prospective studies, met the inclusion criteria. Data were synthesized using a random-effects model. The meta-analysis included 507 women with SUI. Pooled analysis revealed a statistically significant reduction in ICIQ-UI SF scores following laser therapy, with a mean difference of -2.15 (95% CI: -4.26 to -0.05, p=0.05). Substantial heterogeneity was observed (I²=85%, p<0.00001). Studies with longer follow-up periods, such as Okui, 2019 (mean difference: -4.66, 95% CI: -6.89 to -2.43), demonstrated greater improvements. Funnel plot analysis suggested no significant publication bias. Laser therapy significantly improves SUI symptoms, as evidenced by reductions in ICIQ-UI SF scores. However, variability in treatment protocols and study designs underscores the need for standardized approaches and further research to confirm long-term efficacy.

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References

Falah-Hassani K, Reeves J, Shiri R, Hickling D, McLean L. The pathophysiology of stress urinary incontinence: a systematic review and meta-analysis. Int Urogynecol J. 2021;32(3):501-52. DOI: https://doi.org/10.1007/s00192-020-04622-9

Reynolds WS, Dmochowski RR, Penson DF. Epidemiology of stress urinary incontinence in women. Curr Urol Rep. 2011;12(5):370-6. DOI: https://doi.org/10.1007/s11934-011-0206-0

Zhang RQ, Xia MC, Cui F, Chen JW, Bian XD, Xie HJ, Shuang WB. Epidemiological survey of adult female stress urinary incontinence. BMC Womens Health. 2021;21(1):172. DOI: https://doi.org/10.1186/s12905-021-01319-z

Frigerio M, Barba M, Cola A, Braga A, Celardo A, Munno GM, et al. Quality of Life, Psychological Wellbeing, and Sexuality in Women with Urinary Incontinence-Where Are We Now: A Narrative Review. Medicina. 2022;58(4):525. DOI: https://doi.org/10.3390/medicina58040525

Lee HY, Rhee Y, Choi KS. Urinary incontinence and the association with depression, stress, and self-esteem in older Korean Women. Scientific Rep. 2021;11(1):9054. DOI: https://doi.org/10.1038/s41598-021-88740-4

AlQuaiz AM, Kazi A, AlYousefi N, Alwatban L, AlHabib Y, Turkistani I. Urinary Incontinence Affects the Quality of Life and Increases Psychological Distress and Low Self-Esteem. Healthcare (Basel). 2023;11(12):1772. DOI: https://doi.org/10.3390/healthcare11121772

Wu JM. Stress Incontinence in Women. N Engl J Med. 2021;384(25):2428-36. DOI: https://doi.org/10.1056/NEJMcp1914037

Anand A, Khan SM, Khan AA. Stress urinary incontinence in females. Diagnosis and treatment modalities-past, present and the future. J Clin Urol. 2023;16(6):622-30. DOI: https://doi.org/10.1177/20514158211044583

Ruffolo AF, Braga A, Torella M, Frigerio M, Cimmino C, De Rosa A, et al. Vaginal laser therapy for female stress urinary incontinence: New solutions for a well-known issue: A concise review. Medicina. 2022;58(4):512. DOI: https://doi.org/10.3390/medicina58040512

da Fonseca LC, Giarreta FB, Peterson TV, Locali PK, Baracat EC, Ferreira EA, et al. A randomized trial comparing vaginal laser therapy and pelvic floor physical therapy for treating women with stress urinary incontinence. Neurourol Urodynamics. 2023;42(7):1445-54. DOI: https://doi.org/10.1002/nau.25244

O'Reilly BA, Viereck V, Phillips C, Toozs‐Hobson P, Kuhn A, Athanasiou S, et al. Vaginal erbium laser treatment for stress urinary incontinence: A multicenter randomized sham‐controlled clinical trial. Int J Gynecol Obstetr. 2024;164(3):1184-94. DOI: https://doi.org/10.1002/ijgo.15222

Dabaja H, Lauterbach R, Matanes E, Gruenwald I, Lowenstein L. The safety and efficacy of CO2 laser in the treatment of stress urinary incontinence. International Urogynecology J. 2020;31:1691-6. DOI: https://doi.org/10.1007/s00192-019-04204-4

Kuszka A, Gamper M, Walser C, Kociszewski J, Viereck V. Erbium: YAG laser treatment of female stress urinary incontinence: midterm data. International Urogynecology J. 2020;31:1859-66. DOI: https://doi.org/10.1007/s00192-019-04148-9

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. DOI: https://doi.org/10.1136/bmj.n71

Aguiar LB, Politano CA, Costa-Paiva L, Juliato CRT. Efficacy of Fractional CO2 Laser, Promestriene, and Vaginal Lubricant in the Treatment of Urinary Symptoms in Postmenopausal Women: A Randomized Clinical Trial. Lasers Surg Med. 2020;52(8):713-20. DOI: https://doi.org/10.1002/lsm.23220

Alexander JW, Karjalainen P, Ow LL, Kulkarni M, Lee JK, Karjalainen T, et al. CO2 surgical laser for treatment of stress urinary incontinence in women: a randomized controlled trial. Am J Obstet Gynecol. 2022;227(3):473.e1-2. DOI: https://doi.org/10.1016/j.ajog.2022.05.054

Lauterbach R, Aharoni S, Justman N, Farago N, Gruenwald I, Lowenstein L. The efficacy and safety of a single maintenance laser treatment for stress urinary incontinence: a double-blinded randomized controlled trial. Int Urogynecol J. 2022;33(12):3499-504. DOI: https://doi.org/10.1007/s00192-022-05103-x

Lin HY, Tsai HW, Tsui KH, An YF, Lo CC, Lin ZH, et al. The short-term outcome of laser in the management of female pelvic floor disorders: Focus on stress urine incontinence and sexual dysfunction. Taiwan J Obstet Gynecol. 2018;57(6):825-9. DOI: https://doi.org/10.1016/j.tjog.2018.10.010

Okui N. 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;37(5):885-9. DOI: https://doi.org/10.1007/s00345-018-2445-x

Seki AS, Bianchi-Ferraro AMHM, Fonseca ESM, Sartori MGF, Girão MJBC, Jarmy-Di Bella ZIK. CO2 Laser and radiofrequency compared to a sham control group in treatment of stress urinary incontinence (LARF study arm 3). A randomized controlled trial. Int Urogynecol J. 2022;33(12):3535-42. DOI: https://doi.org/10.1007/s00192-022-05091-y

Frederice CP, Brito LGO, Machado HC, Reis AM, Fernandes JO, Juliato CRT. Vaginal stretching therapy and class IIIB vaginal laser treatment for pelvic floor myofascial pain: a randomized clinical trial. Lasers Med Sci. 2022 Jul;37(5):2421-30. DOI: https://doi.org/10.1007/s10103-022-03501-7

Page AS, Borowski E, Bauters E, Housmans S, Van der Aa F, Deprest J. Vaginal erbium laser versus pelvic floor exercises for the treatment of pelvic organ prolapse: A randomised controlled trial. Eur J Obstet Gynecol Reprod Biol. 2024;303:165-170. DOI: https://doi.org/10.1016/j.ejogrb.2024.10.042

Rocha-Rangel SC, Pereira GMV, Juliato CRT, Brito LGO. Laser and Pelvic Floor Muscle Training for Urinary Incontinence: A Randomized Clinical Trial. Urogynecology (Phila). 2024. DOI: https://doi.org/10.1097/SPV.0000000000001516

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Published

2025-02-28

How to Cite

Alkhamis, F. H. (2025). Laser therapy for stress urinary incontinence in women: a systematic review and meta-analysis. International Journal Of Community Medicine And Public Health, 12(3), 1448–1454. https://doi.org/10.18203/2394-6040.ijcmph20250635

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Section

Meta-Analysis