Short-Term Superiority of Transvaginal CO₂ Laser versus Radiofrequency in Stress Urinary Incontinence: A 12-Month...

Approximately 20% of females experience stress urinary incontinence (SUI) during their lifetime. Emerging energy-based therapies, such as CO₂ laser and radiofrequency (RF), lack comparative evidence regarding efficacy stratification based on disease severity and patient characteristics.

This study aims to compare the 6- and 12-month outcomes of transvaginal dot-matrix CO₂ laser therapy versus AI temperature-controlled RF therapy in SUI patients, categorized by symptom severity.

A retrospective analysis was conducted on 106 women (52 treated with laser therapy and 54 with RF therapy) who received standardized treatments. Primary outcomes included the reduction in the 1-hour urine pad test and changes in Questionnaire of International Consultation on Incontinence Questionnaire-Short Form (ICI-Q-SF) scores, while secondary outcomes comprised Patient Global Impression of Improvement (PGI-I) scores and complication rates.

After 6 months, the laser group exhibited a higher overall effective rate compared to the RF group (86.5% vs. 70.4%), with particularly superior outcomes in patients with mild SUI (pad test: 92.6% vs. 58.8%, p=0.017; ICI-Q-SF: 5.35 ± 3.11 vs. 6.98 ± 3.86, p<0.05). After 12 months, therapeutic equivalence was observed across all SUI severities, although RF demonstrated better sustained efficacy in moderate to severe cases (pad test: 70.27% vs. 40%, p=0.018; PGI-I: 2.87±0.89 vs. 3.37±1.01, p=0.009).

CO₂ laser therapy provides rapid symptom control for mild SUI, whereas RF therapy offers greater durability in more severe cases. These findings suggest that treatment modality selection should be personalized based on the severity of the disease and duration.