Is Vaginal Laser Effective for Overactive Bladder? Results of a Systematic Review
- 2 Downloads
Purpose of Review
The aim of this review is to determine the efficacy of laser treatment in overactive bladder (OAB) syndrome in women.
In international literature, there are few studies focusing on OAB symptoms. The proposed treatments included thulium laser, fractional CO2 laser and Erbium:YAG laser.
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.
KeywordsOveractive bladder Laser treatment Vaginal laser Genitourinary syndrome of menopause Incontinence Female
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.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 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.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
- 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
- 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.•• 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
- 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
- 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.
- 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.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
- 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.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
- 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
- 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
- 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