Alcalay Menachem, Ben Ami Moshe, Greenshpun Anatoly, Hagay Zion, Schiff Eyal
Department of Obstetrics and Gynecology, Urogynecology Unit, Pade Poria Medical Center, Tiberias, Israel, 1520800.
Azrieli School of Medicine, Bar Ilan University, Ramat Gan, Israel, 5290002.
Lasers Surg Med. 2021 Sep;53(7):960-967. doi: 10.1002/lsm.23329. Epub 2020 Sep 23.
Vaginal pixelated low power and long pulses (LPLP) CO laser has been suggested as an optional treatment for stress urinary incontinence (SUI) with many studies reporting short-term improvements. The objective of this study was to assess the 1-year subjective and objective efficacy of vaginal CO laser in women with urodynamic SUI.
STUDY DESIGN/MATERIALS AND METHODS: This was a prospective multicenter study. Patients with confirmed urodynamic SUI graded as mild or moderate were included. We used three sessions of fractional pixelated CO laser for vaginal application and followed up the patients at 6 and 12 months. We used the following measures at follow-up: 1-hour pad test (ICS protocol), questionnaires including Pelvic Floor Distress Inventory 20 (PFDI-20), Pelvic Floor Impact Questionnaire (PFIQ), Patient Global Impression of Improvement (PGI-I), and a 3-day urinary diary. The urodynamic assessment was repeated at 6 months.
Fifty-two patients with SUI had three laser treatments, of whom 48 completed a 6-month follow-up and 42 patients completed 12-month follow-up. No serious adverse events were recorded during the study period. A significant reduction on the 1-hour pad test was found from baseline (6.3 ± 1.6 g) to the 12-month follow-up (3.7 ± 1.4 g, P < 0.05) was found. PGI-I showed 75.0%, 61.9%, and 64.3% improvements at 3, 6, and 12 months, respectively. PFDI improved significantly and consistently from baseline until 12 months (37.2 ± 3.89 to 16.1 ± 3.7, P < 0.05). Similarly, PFIQ showed significant improvements from the first treatment up to 12 months. Urodynamic assessment at 6 months showed that 41.4% of patients had no stress incontinence.
The vaginal CO laser was found to be effective for mild-to-moderate SUI over a follow-up period of 1 year, according to a variety of objective and subjective parameters. The wide range of parameters enables optimal patient consultation and subsequent treatment. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
阴道像素化低能量长脉冲（LPLP）CO2激光已被提议作为压力性尿失禁（SUI）的一种可选治疗方法，许多研究报告了其短期改善效果。本研究的目的是评估阴道CO2激光对尿动力学确诊的SUI女性患者的1年主观和客观疗效。
研究设计/材料与方法：这是一项前瞻性多中心研究。纳入确诊为轻度或中度尿动力学SUI的患者。我们对阴道应用了三次分次像素化CO2激光，并在6个月和12个月时对患者进行随访。随访时我们采用了以下测量方法：1小时护垫试验（国际尿控学会方案）、包括盆底困扰量表20（PFDI - 20）、盆底影响问卷（PFIQ）、患者整体改善印象（PGI - I）的问卷以及3天排尿日记。在6个月时重复进行尿动力学评估。
52例SUI患者接受了三次激光治疗，其中48例完成了6个月随访，42例完成了12个月随访。研究期间未记录到严重不良事件。从基线（6.3±1.6 g）到第12个月随访（变得）发现1小时护垫试验有显著降低（3.7±1.4 g，P<0.05）。PGI - I在3个月、6个月和12个月时分别显示改善75.0%、61.
