Gaspar Adrian, Brandi Hugo
Gynecology Department, Faculty of Medicine, Mendoza University, Av. Boulogne Sur Mer 683, 5500 Capital, Mendoza, Argentina.
Lasers Med Sci. 2017 Apr;32(3):685-691. doi: 10.1007/s10103-017-2170-5. Epub 2017 Feb 16.
The objective of this pilot study was to determine the safety and efficacy of a new non-ablative erbium YAG laser procedure for the treatment of type III stress urinary incontinence (intrinsic sphincter deficiency) in women. Twenty-two patients with a Valsalva leak point pressure less than 60 cm H2O were recruited and treated with a non-ablative erbium laser delivering low fluence pulses inside the whole length of the urethra through a specially designed cannula. Treatment consisted of two treatment sessions with a 3-week interval in-between. Therapeutic efficacy, as assessed by a questionnaire addressing quality of life during urinary incontinence and the 1-h pad test, was measured at 3 and 6 months after the procedure. Both methods of assessment showed similar levels of improvement in terms of incontinence severity and improvement in quality of life. All patients tolerated the therapy well and adverse effects were mild and transient. The results of this pilot study showed significant improvement of type III stress urinary incontinence. Despite the limitations of this study, being small patient number and short follow-up, this non-ablative intraurethral erbium YAG laser procedure seems to be a safe and efficacious alternative for patients with type III stress urinary incontinence. More controlled studies should be performed to confirm this data and to evaluate the long-term effects.
这项初步研究的目的是确定一种新型非剥脱性铒钇铝石榴石激光手术治疗女性III型压力性尿失禁（内在括约肌缺陷）的安全性和有效性。招募了22名瓦尔萨尔瓦漏尿点压力低于60 cm H2O的患者，通过特制的套管，使用非剥脱性铒激光在尿道全长内发射低能量脉冲进行治疗。治疗包括两个疗程，中间间隔3周。通过一份关于尿失禁期间生活质量的问卷和1小时护垫试验评估治疗效果，在手术后3个月和6个月进行测量。两种评估方法在尿失禁严重程度和生活质量改善方面都显示出相似的改善水平。所有患者对治疗耐受性良好，不良反应轻微且短暂。这项初步研究的结果显示III型压力性尿失禁有显著改善。尽管本研究存在局限性，即患者数量少且随访时间短，但这种非剥脱性尿道内铒钇铝石榴石激光手术似乎是III型压力性尿失禁患者的一种安全有效的替代方法。应进行更多对照研究以证实这些数据并评估长期效果。
