Department of Obstetrics and Gynecology, Kuang Tien General Hospital, Taichung, Taiwan.
Department of Obstetrics and Gynecology, Chung Shang Medical University Hospital, Taichung, Taiwan.
Taiwan J Obstet Gynecol. 2019 Sep;58(5):610-613. doi: 10.1016/j.tjog.2019.07.006.
This prospective study presents a preliminary result to compare the clinical efficacy of patients with stress urinary incontinence and mixed urinary incontinence using minimal invasive Er:YAG vaginal laser.
A total of 20 patients were included, in which were 10 patients with SUI and 10 patients with MUI (stress and urge incontinence), and underwent a 2940 nm Er:YAG laser with a special SMOOTH mode in an outpatient office without anesthesia or postoperative medications. All patients completed two sessions of treatment with an interval time of 28 days. At three months after treatment, all patients were asked to a clinical visit for evaluate the clinical outcome by pre-treatment and post-treatment ICIQ-SF questionnaire. At pretreatment and 3 months after the completion of two therapy sessions, patients were asked to answer the ICIQ-SF questionnaire. The questionnaire consists of three scales for assessment of the treatment outcome of urinary incontinence as: no change (no change score), improvement (decrease score 1-5), and strong improvement (decrease score >5) for two groups of patients with SUI and MUI. All the results were compared by Student's t test with two way analysis of variance between the two groups.
A total of 20 patients presented with SUI symptom relief and improvement with treatment satisfaction. All 10 patients with SUI reported improvement after vaginal laser treatment, 70% with marked improvement and 30% with improvement. All 10 patients with MUI also had improvement, 40% with marked improvement and 60% with improvement. There was no statistically significant difference in the treatment outcome between the two groups.
Vaginal Erbium laser produce provides vaginal collagen remodeling and synthesis that may repair and restore the pelvic floor function. Despite of sample limitation and short follow up, this treating procedure presented a good and a safe clinical outcome in patients with SUI and with MUI by assessment of ICIQ-SF questionnaire.
本前瞻性研究旨在比较微创铒：YAG 阴道激光治疗压力性尿失禁（SUI）和混合性尿失禁（MUI）患者的临床疗效。
共纳入 20 例患者，其中 10 例为 SUI 患者，10 例为 MUI 患者（压力性和急迫性尿失禁），在门诊接受 2940nm 铒：YAG 激光治疗，采用特殊的 SMOOTH 模式，无需麻醉或术后用药。所有患者均完成两次治疗，间隔 28 天。治疗后 3 个月，所有患者均进行临床访视，采用 ICIQ-SF 问卷评估治疗前后的临床疗效。在治疗前和两次治疗完成后 3 个月，患者均需回答 ICIQ-SF 问卷。该问卷由三个量表组成，用于评估尿失禁的治疗效果：无变化（无变化评分）、改善（评分降低 1-5 分）和明显改善（评分降低>5 分），分别用于 SUI 和 MUI 两组患者。采用学生 t 检验和双因素方差分析比较两组患者的结果。
20 例 SUI 患者均有症状缓解和治疗满意度改善。10 例 SUI 患者阴道激光治疗后均有改善，70%为明显改善，30%为改善。10 例 MUI 患者也均有改善，40%为明显改善，60%为改善。两组患者的治疗效果无统计学差异。
阴道铒激光治疗可促进阴道胶原重塑和合成，可能修复和恢复盆底功能。尽管样本量有限且随访时间较短，但本治疗方法通过 ICIQ-SF 问卷评估，对 SUI 和 MUI 患者均具有良好和安全的临床疗效。
