Advertisement

Is Vaginal Laser Effective for Overactive Bladder? Results of a Systematic Review

  • Gloria CalagnaEmail author
  • Marianna Maranto
  • Emanuela Ognibene
  • Salvatore Polito
  • Pasquale De Franciscis
  • Roberta Granese
  • Gaspare Cucinella
Overactive Bladder (U Lee and S Adelstein, Section Editors)
  • 2 Downloads
Part of the following topical collections:
  1. Topical Collection on Overactive Bladder

Abstract

Purpose of Review

The aim of this review is to determine the efficacy of laser treatment in overactive bladder (OAB) syndrome in women.

Recent Findings

In international literature, there are few studies focusing on OAB symptoms. The proposed treatments included thulium laser, fractional CO2 laser and Erbium:YAG laser.

Summary

Although the analysed studies are not RCTs, the results show the efficacy of laser treatment in OAB symptoms, also compared to conventional medical and surgical treatments. However, these tests must be implemented with RCTs and with large patient samples.

Keywords

Overactive bladder Laser treatment Vaginal laser Genitourinary syndrome of menopause Incontinence Female 

Notes

Compliance with Ethical Standards

Conflict of Interest

Gloria Calagna, Marianna Maranto, Ognibene Emanuela, Salvatore Polito, Pasquale De Franciscis, Roberta Granese and Gaspare Cucinella declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29:4–20.  https://doi.org/10.1002/nau.20798.CrossRefGoogle Scholar
  2. 2.
    Irwin DE, Milsom I, Hunskaar S, Reilly K, Kopp Z, Herschorn S, et al. Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol. 2006;50:1306–15.  https://doi.org/10.1016/j.eururo.2006.09.019.CrossRefPubMedGoogle Scholar
  3. 3.
    Steward WF, Van Rooyen JB, CundiffGW AP, Herzog AR, Corey R, et al. Prevalence and burden of overactive bladder in the United States. World J Urol. 2003;20:327–36.  https://doi.org/10.1007/s00345-002-0301-4.CrossRefGoogle Scholar
  4. 4.
    White N, Iglesia CB. Overactive Bladder. Obstet Gynecol Clin N Am. 2016;43:59–68.  https://doi.org/10.1016/j.ogc.2015.10.002.CrossRefGoogle Scholar
  5. 5.
    Abrams P, Kelleher CJ, Kerr LA, Rogers RG. Overactive bladder significantly affects quality of life. Am J Manag Care. 2000;6:S580–90.PubMedGoogle Scholar
  6. 6.
    Nystrom E, Sjostrom M, Stenlund H, Samuelsson E. ICIQ symptom and quality of life instruments measure clinically relevant improvements in women with stress urinary incontinence. Neurourol Urodyn. 2014;34:747–51.  https://doi.org/10.1002/nau.22657.CrossRefPubMedGoogle Scholar
  7. 7.
    Thüroff JW, Abrams P, Andersson KE, Artibani W, Chapple CR, Drake MJ, et al. EAU Guidelines on Urinary Incontinence. Eur Urol. 2011;59:387–400.  https://doi.org/10.1016/j.eururo.2010.11.021.CrossRefPubMedGoogle Scholar
  8. 8.
    • Chapple CR, Khullar V, Gabriel Z, Muston D, Bitoun CE, Weinstein D. The effects of antimuscarinic treatments in overactive bladder: an update of a systematic review and meta-analysis. Eur Urol. 2008;54:543–62.  https://doi.org/10.1016/j.eururo.2008.06.047Review and meta-analysis on the main available medical therapy for OAB. CrossRefPubMedGoogle Scholar
  9. 9.
    Liang CC, Hsieh WC, Huang L. Outcome of coexistent overactive bladder symptoms in women with urodynamic urinary incontinence following anti-incontinence surgery. Int Urogynecol J. 2016;28:605–11.  https://doi.org/10.1007/s00192-016-3153-y.CrossRefPubMedGoogle Scholar
  10. 10.
    Athanasiou S, Grigoriadis T, Giannoulis G, Protopapas A, Antsaklis A. Midurethral slings for women with urodynamicmixed incontinence: what to expect? Int Urogynecol J. 2013;24:393–9.  https://doi.org/10.1007/s00192-012-1859-z.CrossRefPubMedGoogle Scholar
  11. 11.
    Jain P, Jirschele K, Botros SM, Latthe PM. Effectiveness of midurethral slings in mixed urinary incontinence: a systematic review and meta-analysis. Int Urogynecol J. 2011;22:923–32.  https://doi.org/10.1007/s00192-011-1406-3.CrossRefPubMedGoogle Scholar
  12. 12.
    Lin YH, Hsieh WC, Huang L, Liang CC. Effect of non-ablative laser treatment on overactive bladder symptoms, urinary incontinence and sexual function in women with urodynamic stress incontinence. Taiwan J Obstet Gynecol. 2017;56:815–20.  https://doi.org/10.1016/j.tjog.2017.10.020.CrossRefPubMedGoogle Scholar
  13. 13.
    •• Perino A, Cucinella G, Gugliotta G, Saitta S, Polito S, Adile B, et al. Is vaginal fractional CO2 laser treatment effective in improving overactive bladder symptoms in post-menopausal patients? Preliminary results. Eur Rev Med Pharmacol Sci. 2016;20:2491–7 One of the first trials on the application of laser CO 2for OAB symptoms. PubMedGoogle Scholar
  14. 14.
    Ogrinc UB, Senčar S, Lenasi H. Novel minimally invasive laser treatment of urinary incontinence in women. Lasers Surg Med. 2015;47:689–97.  https://doi.org/10.1002/lsm.22416.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    •• Athanasiou S, Pitsouni E, Grigoriadis T, Zacharakis D, Falagas ME, Salvatore S, et al. Microablative fractional CO2 laser for the genitourinary syndrome of menopause: up to 12-month results. Menopause. 2019;26:248–55.  https://doi.org/10.1097/GME.0000000000001206This is the most trial on efficacy of laser CO 2for the genitourinary syndrome of menopause. CrossRefPubMedGoogle Scholar
  16. 16.
    Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. Int J Surg. 2010;8:336–41.  https://doi.org/10.1016/j.ijsu.2010.02.007.CrossRefPubMedGoogle Scholar
  17. 17.
    Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.handbook.cochrane.org.
  18. 18.
    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;37:885–9.  https://doi.org/10.1007/s00345-018-2445-x.CrossRefPubMedGoogle Scholar
  19. 19.
    •• Okui N. Efficacy and safety of non-ablative vaginal erbium:YAG laser treatment as a novel surgical treatment for overactive bladder syndrome: comparison with anticholinergics and β3-adrenoceptor agonists. World J Urol. 2019.  https://doi.org/10.1007/s00345-019-02644-7This trial compared erbium:YAG laser treatment vs standard medical therapy. CrossRefGoogle Scholar
  20. 20.
    Tovar-Huamani J, Mercado-Olivares F, Grandez-Urbina JA, Pichardo-Rodriguez R, Tovar-Huamani M, García-Perdomo H. Efficacy of fractional CO2 laser in the treatment of genitourinary syndrome of menopause in Latin American Population: First Peruvian experience. Lasers Surg Med. 2019;51:509–15.  https://doi.org/10.1002/lsm.23066.CrossRefPubMedGoogle Scholar
  21. 21.
    Athanasiou S, Pitsouni E, Antonopoulou S, Zacharakis D, Salvatore S, Falagas ME, et al. The effect of microablative fractional CO2 laser on vaginal flora of postmenopausal women. Climacteric. 2016;19:512–8.  https://doi.org/10.1080/13697137.2016.1212006.CrossRefPubMedGoogle Scholar
  22. 22.
    Pitsouni E, Grigoriadis T, Tsiveleka A, Zacharakis D, Salvatore S, Athanasiou S. Microablative fractional CO2-laser therapy and the genitourinary syndrome of menopause: an observational study. Maturitas. 2016;94:131-136.  https://doi.org/10.1016/j.maturitas.2016.09.012 CrossRefGoogle Scholar
  23. 23.
    Pitsouni E, Grigoriadis T, Falagas ME, Salvatore S, Athanasiou S. Laser therapy for the genitourinary syndrome of menopause. A systematic review and meta-analysis. Maturitas. 2017;103:78–88.  https://doi.org/10.1016/j.maturitas.2017.06.029.CrossRefPubMedGoogle Scholar
  24. 24.
    Salvatore S, Nappi RE, Parma M, Chionna R, Lagona F, Zerbinati N, et al. Sexual function after fractional microablative CO2 laser in women with vulvovaginal atrophy. Climateric. 2015;18:219–25.  https://doi.org/10.3109/13697137.2014.975197.CrossRefGoogle Scholar
  25. 25.
    Perino A, Calligaro A, Forlani F, Tiberio C, Cucinella G, Svelato A, et al. Vulvo-vaginal atrophy: a new treatment modality using thermo-ablative fractional CO2 laser. Maturitas. 2015;80:296–301.  https://doi.org/10.1016/j.maturitas.2014.12.006.CrossRefPubMedGoogle Scholar
  26. 26.
    •• Flint R, Cardozo L, Grigoriadis Rantell TA, Pitsouni E, Athanasiou S. Rationale and design for fractional microablative CO2 laser versus photothermal non-ablative erbium:YAG laser for the management of genitourinary syndrome of menopause: a non-inferiority, single-blind randomized controlled trial. Climacteric. 2019;22:307–11.  https://doi.org/10.1080/13697137.2018This trial compared CO2 laser and erbium:YAG laser for genitourinary syndrome of menopause. CrossRefPubMedGoogle Scholar
  27. 27.
    Gaspar A, Maestri S, Silva J, Brandi H, Luque D, Koron N, Vižintin Z. Intraurethral Erbium: YAG laser for the management of urinary symptoms of genitourinary syndrome of menopause: A pilot study. Lasers in surgery and medicine. 2018;50:802-807.  https://doi.org/10.1002/lsm.22826 CrossRefGoogle Scholar
  28. 28.
    Gaspar A, Brandi H, Gomez V, Luque D. Efficacy of Erbium:YAG laser treatment compared to topical estriol treatment for symptoms of genitourinary syndrome of menopause. Lasers Surg Med. 2016;49:160–16.  https://doi.org/10.1002/lsm.22569.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Drnovsek-Olup B, Beltram M, Pizem J. Repetitive Er:YAG laser irradiation of human skin: A histological evaluation. Lasers Surg Med. 2004;35:146–51.  https://doi.org/10.1002/lsm.20080.CrossRefPubMedGoogle Scholar
  30. 30.
    Tadir Y, Gaspar A, Lev-Sagie A, Alexiades M, Alinsod R, Bader A, et al. Light and energy based therapeutics for genitourinary syndrome of menopause: Consensus and controversies. Laser Surg Med. 2017;49:137–59.  https://doi.org/10.1002/lsm.22637.CrossRefGoogle Scholar
  31. 31.
    Salvatore S, Nappi RE, Zerbinati N, Calligaro A, Ferrero S, Origoni M, et al. A 12-week treatment with fractional CO2 laser for vulvovaginal atrophy: a pilot study. Climacteric. 2014;17:363–9.  https://doi.org/10.3109/13697137.2014.899347.CrossRefPubMedGoogle Scholar
  32. 32.
    • Behnia-Willison F, Sarraf S, Miller J, Mohamadi B, Care AS, Lam A, et al. Safety and long-term efficacy of fractional CO2 laser treatment in women suffering from genitourinary syndrome of menopause. Eur J Obstet Gynecol Reprod Biol. 2017;213:39–44.  https://doi.org/10.1016/j.ejogrb.2017.03.036This trial reported data on long-term efficacy of CO 2laser for genitourinary syndrome of menopause. CrossRefPubMedGoogle Scholar
  33. 33.
    Gaspar A, Addamo G, Brandi H. Vaginal fractional CO2 laser: a minimally invasive option for vaginal rejuvenation. Am J Cosmet Surg. 2011;28:156–62.  https://doi.org/10.1177/074880681102800309.CrossRefGoogle Scholar
  34. 34.
    Gandhi J, Chen A, Dagur G, Suh Y, Smith N, Cali B, et al. Genitourinary syndrome of menopause: an overview of clinical manifestations, pathophysiology, etiology, evaluation, and management. Am J Obstet Gynecol. 2016:704–11.  https://doi.org/10.1016/j.ajog.2016.07.045.CrossRefGoogle Scholar
  35. 35.
    Abrams P, Andersson KE, Buccafusco JJ, Chapple C, de Groat WC, Fryer AD, et al. Muscarinic receptors: their distribution and function in body systems, and the implications for treating overactive bladder. Br J Pharm. 2006;148:565–78.  https://doi.org/10.1038/sj.bjp.0706780.CrossRefGoogle Scholar
  36. 36.
    Benner JS, Nichol MB, Rovner ES, Jumadilova Z, Alvir J, Hussein M, et al. Patient-reported reasons for discontinuing overactive bladder medication. BJU Int. 2010;105:1276–82.  https://doi.org/10.1111/j.1464-410X.2009.09036.x.CrossRefPubMedGoogle Scholar
  37. 37.
    Kumar V, Templeman L, Chapple CR, Chess-Williams R. Recent developments in the management of detrusor overactivity. Curr Opin Urol. 2003;13:285–91.  https://doi.org/10.1097/01.mou.0000079412.62186.66.CrossRefPubMedGoogle Scholar
  38. 38.
    Duthie JB, Vincent M, Herbison GP, Wilson DI, Wilson D. Botulinum toxin injections for adults with overactive bladder syndrome. Cochrane Database Syst Rev. 2011;7:CD005493.  https://doi.org/10.1002/14651858.CD005493.pub3.CrossRefGoogle Scholar
  39. 39.
    Adile B, Speciale P, Gugliotta G, Consiglio P, Manzone M, Adile G, et al. Efficacy and acceptance of the sacral neuromodulation in the treatment of female lower urinary tract dysfunctions. Minerva Ginecol. 2018;70:236–8.  https://doi.org/10.23736/S0026-4784.17.04135-1.CrossRefPubMedGoogle Scholar
  40. 40.
    McGuire EJ, Fitzpatrick CC, WanJ BD, Sanvordenker J, Ritchey M, et al. Clinical assessment of urethral sphincter function. J Urol. 1993;150:1452–4.  https://doi.org/10.1016/s0022-5347(17)35806-8.CrossRefPubMedGoogle Scholar
  41. 41.
    Smith P. Estrogens and the urogenital tract. Studies on steroid hormone receptors and a clinical study on a new estradiol-releasing vaginal ring. Acta Obstet Gynecol Scand. 1993;157:1–25.Google Scholar
  42. 42.
    Falconer C, Ekman-Ordeberg G, Ulmsten U, Westergren-Thorsson G, Barchan K, Malmstrom A. Changes in paraurethral connective tissue at menopause are counteracted by estrogen. Maturitas. 1996;24:197–204.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Gloria Calagna
    • 1
    Email author
  • Marianna Maranto
    • 1
  • Emanuela Ognibene
    • 1
  • Salvatore Polito
    • 1
  • Pasquale De Franciscis
    • 2
  • Roberta Granese
    • 3
  • Gaspare Cucinella
    • 1
  1. 1.Obstetrics and Gynecology Unit, “Villa Sofia Cervello” HospitalUniversity of PalermoPalermoItaly
  2. 2.Department of Woman, Child and of General and Specialist SurgerySecond University of NaplesNaplesItaly
  3. 3.Obstetrics and Gynecology Unit, Department of Human Pathology of Adult and Childhood “G. Barresi”University Hospital “G. Martino”MessinaItaly

Personalised recommendations