掺铒钇铝石榴石激光治疗压力性尿失禁的疗效与安全性：一项系统评价和荟萃分析
The Efficacy and Safety of Erbium-Doped Yttrium Aluminum Garnet Laser Therapy for Stress Urinary Incontinence: A Systematic Review and Meta-Analysis.
作者信息
Yan Huilei, Wang Jialei, Ding Yefei, Huang Guanli, Ding Hao, Zhao Wei, Ma Yunbo
机构信息
Department of Urology, Liaocheng People's Hospital, Liaocheng, China.
出版信息
Lasers Surg Med. 2025 Apr;57(4):297-305. doi: 10.1002/lsm.70012. Epub 2025 Apr 6.
OBJECTIVES
The erbium-doped yttrium aluminum garnet(Er:YAG) laser therapy has recently emerged as a novel treatment for stress urinary incontinence (SUI) in women. The purpose of this meta-analysis was to evaluate the efficacy and safety of Er:YAG laser therapy in the management of SUI.
MATERIALS AND METHODS
We conducted a search in the databases MEDLINE, EMBASE, and the Cochrane Library, up to December 2024, to identify randomized controlled trials (RCTs) that mentioned the use of Er:YAG laser therapy for the treatment of SUI. A systematic review and meta-analysis was conducted.
RESULTS
The meta-analysis included four publications with a total of 390 patients diagnosed with SUI. Posttreatment analysis revealed statistically significant improvements in the Er:YAG laser therapy group for the 1-h pad test (mean difference [MD]: -10.42; 95% confidence interval [CI], -17.32 to -3.53; p = 0.003) and the number of subjective cures as assessed by the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) (odds ratio [OR]; 6.21, 95% CI; 1.55-24.84, p = 0.01). However, no significant differences were observed in the change of ICIQ-SF scores (MD: -0.15; 95% CI, -0.77 to 1.07; p = 0.75) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) scores (MD: 0.81; 95% CI, -0.24 to 1.85; p = 0.13). In terms of comfort, pain visual analog score (VAS) was higher in the laser therapy versus sham therapy following both treatment sessions (The pain VAS after session one (MD; 3.72, 95% CI; 3.24-419, p < 0.00001). The pain VAS after session two(MD; 2.64, 95% CI; 2.12-3.15, p < 0.00001). Regarding adverse events, there were no statistically significant differences between the Er:YAG laser group and the sham group in terms of increased vaginal discharge (OR; 4.64, 95% CI; 0.27-78.30, p = 0.29), vaginal discomfort (OR; 1.31, 95% CI; 0.62-2.73, p = 0.48), and suspected urinary tract infection (UTI) (OR; 3.44, 95% CI; 0.57-20.58, p = 0.18).
CONCLUSIONS
Our meta-analysis indicates that the Er:YAG laser appears to be a safe and effective treatment option for SUI.
目的
掺铒钇铝石榴石（Er:YAG）激光疗法最近已成为一种治疗女性压力性尿失禁（SUI）的新方法。本荟萃分析的目的是评估Er:YAG激光疗法治疗SUI的有效性和安全性。
材料和方法
我们在MEDLINE、EMBASE和Cochrane图书馆数据库中进行了检索，截至2024年12月，以确定提及使用Er:YAG激光疗法治疗SUI的随机对照试验（RCT）。进行了系统评价和荟萃分析。
结果
荟萃分析纳入了4篇文献，共390例诊断为SUI的患者。治疗后分析显示，Er:YAG激光治疗组在1小时垫试验（平均差[MD]：-10.42；95%置信区间[CI]，-17.32至-3.53；p = 0.003）以及根据国际尿失禁咨询问卷简表（ICIQ-SF）评估的主观治愈人数方面有统计学意义的改善（比值比[OR]；6.21，95%CI；1.55 - 24.84，p = 0.01）。然而，在ICIQ-SF评分变化（MD：-0.15；95%CI，-0.77至1.07；p = 0.75）和盆腔器官脱垂/尿失禁性功能问卷（PISQ-12）评分变化（MD：0.81；95%CI，-0.24至1.85；p = 0.13）方面未观察到显著差异。在舒适度方面，两个治疗疗程后激光治疗组的疼痛视觉模拟评分（VAS）均高于假治疗组（第一个疗程后的疼痛VAS（MD；3.72，95%CI；3.24 - 4.19，p < 0.00001）。第二个疗程后的疼痛VAS（MD；2.64，95%CI；2.12 - 3.15，p < 0.00001）。关于不良事件，Er:YAG激光组和假治疗组在阴道分泌物增多（OR；4.64，95%CI；0.27 - 78.30，p = 0.29）、阴道不适（OR；1.31，95%CI；0.62 - 2.73，p = 0.48）和疑似尿路感染（UTI）（OR；3.44，95%CI；0.57 - 20.58，p = 0.18）方面无统计学显著差异。
结论
我们的荟萃分析表明，Er:YAG激光似乎是一种治疗SUI的安全有效的选择。
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