Uro-Gyn.Net Health Care Cooperation, Dr. Okui's Urogynecology and Urology Clinic, Kanagawa, Japan.
World J Urol. 2019 May;37(5):885-889. doi: 10.1007/s00345-018-2445-x. Epub 2018 Aug 16.
Stress urinary incontinence (SUI) and mixed urinary incontinence (MUI) lead to poor quality of life. In Japan, urinary incontinence is treated with tension-free vaginal tape (TVT) or transobturator tape (TOT) sling procedures, which involves inserting a synthetic material; however, problems arise with artificial mesh in some instances, requiring new treatment methods. Hence, laser therapy, whereby an erbium-doped yttrium aluminum garnet laser is directed into the vagina and urethra, may be useful. The study aimed to compare the effects of these three treatments.
Subjects included patients who received TVT, TOT, or laser therapy (n = 50 each). The 1-h pad test, International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), and overactive bladder symptom score were used to assess the patients before and 12 months after treatment. For laser therapy, a probe was inserted into the vagina after applying a local anesthetic to the vaginal wall, and irradiation was performed for 20 min at a wavelength of 2940 nm. This treatment was performed three times every alternate month.
As per the 1-h pad test and ICIQ-SF, the TVT, TOT, and laser therapy groups showed comparable improvements in SUI. For patients with MUI, some in the TVT and TOT groups showed exacerbation; however, all patients in the laser therapy group tended to improve.
The efficacy of laser therapy for urinary incontinence was confirmed. This is the first study to report on the effect of laser therapy on urinary incontinence in Japanese women.
压力性尿失禁（SUI）和混合性尿失禁（MUI）导致生活质量下降。在日本，尿失禁采用经阴道无张力吊带（TVT）或经闭孔吊带（TOT）吊带手术治疗，这涉及插入合成材料；然而，在某些情况下，人造网会出现问题，需要新的治疗方法。因此，激光治疗，即向阴道和尿道内发射掺铒钇铝石榴石激光，可能会有所帮助。本研究旨在比较这三种治疗方法的效果。
研究对象包括接受 TVT、TOT 或激光治疗的患者（每组各 50 例）。在治疗前和治疗后 12 个月，使用 1 小时尿垫试验、国际尿失禁咨询问卷简表（ICIQ-SF）和膀胱过度活动症症状评分评估患者。对于激光治疗，在阴道壁局部麻醉后将探头插入阴道，在 2940nm 波长下照射 20 分钟。这种治疗每两个月进行三次。
根据 1 小时尿垫试验和 ICIQ-SF，TVT、TOT 和激光治疗组在 SUI 方面均显示出可比的改善。对于 MUI 患者，一些 TVT 和 TOT 组患者病情恶化；然而，激光治疗组的所有患者均倾向于改善。
激光治疗尿失禁的疗效得到了证实。这是第一项报告激光治疗对日本女性尿失禁影响的研究。
