Vaginal Erbium Laser Versus Pelvic Floor Muscle Training for Stress Urinary Incontinence: A Randomised Controlled...

Area of Science:

• Urology
• Gynecology
• Pelvic Health

Background:

• Current evidence on vaginal laser therapy for stress urinary incontinence (SUI) is inconclusive.
• Many studies lack direct comparison with established conservative treatments like pelvic floor muscle training (PFMT).
• There is a need to evaluate alternative SUI management options.

Purpose of the Study:

• To compare the efficacy of Er:YAG laser therapy with PFMT for managing mild to moderate SUI.
• To assess subjective and objective outcomes, including adverse events, up to 24 months post-treatment.

Main Methods:

• A single-center, randomized controlled trial was conducted.
• Participants received either vaginal laser treatment (3-6 applications) or PFMT (9-18 sessions).
• The primary outcome measure was the change in Urogenital Distress Inventory-6 (UDI-6) scores at 4 months; secondary outcomes were assessed up to 24 months.

Main Results:

• The study included 60 women with mild to moderate SUI.
• Er:YAG laser therapy was non-inferior to PFMT at 4 months, with comparable improvements in UDI-6 scores.
• Subjective cure rates were low in both groups (11% for laser, 8% for PFMT), and most patients desired further treatment by 24 months. No serious adverse events were reported.

Conclusions:

• Vaginal laser therapy and PFMT demonstrated comparable, yet limited and short-lasting, treatment effects for mild to moderate SUI.
• Both interventions were found to be safe, with no reported adverse events.
• The long-term efficacy of both treatments appears limited, with a majority of patients seeking additional interventions.