The Long-Term Effectiveness of Fractional CO₂ Laser in Stress Urinary Incontinence: A Two-Year Follow-Up Study

Area of Science:

• Gynecology
• Urology
• Dermatology

Background:

• Stress urinary incontinence (SUI) significantly impacts women's quality of life.
• Non-surgical treatment options are sought for SUI management.

Purpose of the Study:

• To assess the long-term effectiveness and durability of fractional CO2 laser therapy for SUI over a 2-year period.
• To evaluate its impact on sexual function, vaginal symptoms, and genital self-image.

Main Methods:

• Retrospective cohort study of 215 women with SUI treated with fractional CO2 laser.
• Assessments included patient-reported satisfaction, Michigan Incontinence Symptom Index (MISI), Female Sexual Function Index (FSFI), Vaginal Symptom Questionnaire (VSQ), and Female Genital Self-Image Scale (FGSIS) at baseline, 4-6 weeks, 1 year, and 2 years.
• Statistical analysis using repeated measures ANOVA and post hoc tests.

Main Results:

• Significant improvements were observed in SUI symptoms, satisfaction, sexual function, vaginal symptoms, and genital self-image throughout the 2-year follow-up (p<0.0001).
• Effects peaked at 4-6 weeks, were largely maintained at 1 year, and remained significantly superior to baseline at 2 years, despite a partial decline.
• Approximately 20% of participants required additional sessions in the second year due to symptom recurrence.

Conclusions:

• Fractional CO2 laser therapy offers a safe and effective minimally invasive treatment for SUI.
• It provides sustained improvements in SUI symptoms and associated quality of life metrics, including sexual function and vaginal comfort.
• The procedure demonstrates long-term efficacy, with most benefits persisting beyond one year.