Topical hyaluronic acid and oxygen for urinary incontinence: a double-center retrospective study

This study aimed to evaluate the effects of low-molecular-weight hyaluronic acid (LMWHA) solution and high-concentration oxygen (HCO) through a specific medical device (Caress Flow©), compared to topical administration of hyaluronic acid (HA) alone, on symptoms of mild and moderate stress and mixed urinary incontinence in women with genitourinary syndrome of menopause (GSM).

A total of 68 postmenopausal women were registered (from October 2021 to September 2023). Patients were divided into two groups: one group received therapy with LMWHA solution and HCO combined, and the second group received HA therapy alone. The primary outcome was the Patient Global Impression of Improvement (PGI-I). Secondary outcomes included the International Consultation on Incontinence Questionnaire-short form (ICIQ-SF) questionnaire and the International Quality of Life (IQoL) questionnaire.

Of the 68 women, 35 (51%) and 33 (49%) were treated with LMWHA solution and HCO combined and HA alone for 10 weeks, respectively. A total of 28 (80%) vs. 7 (21%) women reported an improvement (PGI-I score ≤3) of the symptoms in the LMWHA solution and HCO combined group vs. the HA alone group. According to the ICIQ-SF, a statistically significant difference was observed between the two groups after treatment (median, 7 [5-11] vs. 10 [8-11]; p = 0.03). The IQoL questionnaire recorded a statistically significantly lower median score in the LMWHA solution and HCO combined group compared with the HA group, before (71 [IQR 55-81] vs. 89 [IQR 67-94]; p < 0.01) and after (78 [IQR 65-86] vs. 88 [IQR 72-99]; p = 0.04) treatment.

LMWHA solution and HCO combined might improve mild and moderate stress and mixed urinary incontinence in women with GSM and appear superior to HA therapy alone. However, these results need to be confirmed in further studies with a controlled design and a larger population.