Abstract
Aim: Approximately 25-45% of women and 5-10% of men experience urinary incontinence at some point in their lives. CO2 laser treatment is used as an alternative to surgical treatment for stress urinary incontinence. The main goal of this study is to present the results of laser treatment applied to our own patients and to prove that the laser technique could be more beneficial for patients who do not require surgical intervention.
Materials and Methods: In our research conducted at the Obstetrics and Gynecology Department of the Central Customs Hospital, 28 women who presented with stress urinary incontinence were included in the study. The study covers patients who received laser treatment between October 2023 and August 2024.
Results: Among the 28 women who presented to our clinic with stress urinary incontinence, 11 (39.3%) were aged 30-40, 7 (25%) were aged 40-50, and 10 (35.7%) were aged 50 and above (Table 1). Of the 28 patients, 18 (64.2%) had vaginal deliveries, 4 (14.3%) had cesarean deliveries, and 6 (21.5%) had combined deliveries. The average age of the patients was 42.8±1.4 years (range: 30-70), the average number of births was 2.3±0.1 (0-3), and the average BMI was 27.2±0.4 (22-31). Of the 28 patients, 26 (92.8%) reported being satisfied with the results and reported significant improvement, while 2 (7.2%) patients did not respond to vaginal laser treatment, and the expected results were not achieved.
Conclusion: Stress urinary incontinence is a health problem that leads to a decrease in patients' quality of life. Vaginal laser therapy has recently gained significant importance in the treatment of stress urinary incontinence. The thermal effect of CO2 laser radiation on the tissue stimulates the inflammatory healing of fibroblasts, triggering de novo collagen and elastin synthesis. This results in the formation of thicker vaginal epithelium and larger epithelial cells. Significant improvement has been observed in patients who complete the full course of CO2 laser therapy.
References
- Rovner, E. S., & Wein, A. J. (2004). Treatment options for stress urinary incontinence. Reviews in urology, 6 (Suppl 3), S29.
- Moroni, R. M., Magnani, P. S., Haddad, J. M., Castro, R. D. A., & Brito, L. G. O. (2016). Conservative treatment of stress urinary incontinence: a systematic review with meta-analysis of randomized controlled trials. Revista Brasileira de Ginecologia e Obstetrícia, 38(2), 97-111.
- Ruffolo, A. F., Braga, A., Torella, M., Frigerio, M., Cimmino, C., De Rosa, A. & Serati, M. (2022). Vaginal laser therapy for female stress urinary incontinence: New solutions for a well-known issue-A concise review. Medicina, 58(4), 512.
- Conté, C., Jauffret, T., Vieillefosse, S., Hermieu, J. F., & Deffieux, X. (2017). Laser procedure for female urinary stress incontinence: a review of the literature. Progrès en urologie, 27(17), 1076-1083.
- Ogrinc, U. B., Senčar, S., & Lenasi, H. (2015). Novel minimally invasive laser treatment of urinary incontinence in women. Lasers in surgery and medicine, 47(9), 689-697.
- Committee Opinion No. 603: Evaluation of uncomplicated stress urinary incontinence in women before surgical treatment. Obstet Gynecol. 2014 Jun; 123(6):1403-1407.
- Behnia-Willison, Fariba, et al. "Fractional CO2 laser for treatment of stress urinary incontinence." European Journal of Obstetrics & Gynecology and Reproductive Biology: X 1 (2019): 100004.
- Hafidh, Bandr, et al. "CO2 laser therapy for management of stress urinary incontinence in women: a systematic review and meta-analysis." Therapeutic Advances in Urology 15 (2023): 17562872231210216.
- Menachem, Alcalay, et al. "The effect of vaginal CO2 laser treatment on stress urinary incontinence symptoms." Alma Surgical (2016).
- Nygaard I, Barber MD, Burgio KL, Kenton K, Meikle S, Schaffer J, Spino C, Whitehead WE, Wu J, Brody DJ., Pelvic Floor Disorders Network. Prevalence of symptomatic pelvic floor disorders in US women. JAMA. 2008 Sep 17;300(11):1311-6.
- Long, Cheng-Yu, et al. "The clinical effects of pixel CO2 laser on bladder neck and stress urinary incontinence." Journal of Clinical Medicine 11.17 (2022): 4971.
- Tania Lugo; John Riggs. Stress Incontinence. Last Update: June 26, 2023.
- Dabaja, Hanin, et al. "The safety and efficacy of CO 2 laser in the treatment of stress urinary incontinence." International Urogynecology Journal 31 (2020): 1691-1696.
- Rovner ES, Wein AJ. Treatment options for stress urinary incontinence. Rev Urol. 2004; 6 Suppl 3:S, 29-47.
- Nadia A. Ibrahim, Lutfi G. Awazli. "Stress Urinary Incontinence Treatment Using Vaginal Fractional CO2 Laser (10600nm)." Iraqi Journal of Laser 18.2 (2019): 7-13.
- AA Nalewczynska, M Barwijuk, P Kolczewski. Pixel-CO2 laser for the treatment of stress urinary incontinence. - Lasers in Medical Science, Original Article, volume 37, (2022): 1061-1067
- Alcalay, Menachem, et al. "Fractional-pixel CO2 laser treatment in patients with urodynamic stress urinary incontinence: 1-year follow-up." Lasers in Surgery and Medicine 53.7 (2021): 960-967.
- Novara G, Artibani W, Barber MD, et al. Updated systematic review and meta-analysis of the comparative data on colposuspensions, pubovaginal slings, and midurethral tapes in the surgical treatment of female stress urinary incontinence. Eur Urol. Aug 2010; 58 (2):218-238.
Abstract
Amaç: Dünyada kadınların yaklaşık %25-45'i, erkeklerin ise %5-10'u hayatlarının bir döneminde üriner inkontinans yaşamaktadır. Stress üriner inkontinans tedavisinde CO2 lazer uygulaması cerrahi tedaviye alternatif olarak yapılmaktadır. Çalışmamızda esas amaç kendi hastalarımıza uyguladığımız lazer tedavi sonuçlarını ortaya koymak, lazer tekniğinin daha modern, cerrahi ameliyyat gerektirmeyen hastalar için daha faydalı ola bileceyini kanıtlamakdır.
Gereç ve Yöntem: Merkezi Gömrük Hospitalı Kadın Hastalıkları ve Doğum bölümünde yaptığımız araştırmada stress üriner inkontinans nedeniyle baş vuran 28 kadın hasta incelenmeye alındı. Çalışma Ekim 2023-Ağustos 2024 tarihleri arasında lazer tedavisi gören hastaları kapsamaktadır.
Bulgular: Stress ürinar inkontinans nedeniyle kliniğimize baş vuran 28 kadın hastanın 11-i (%39.3) 30-40 yaş, 7 hasta (%25) 40-50 yaş, 10 hasta (%35,7) ise 50 yaş ve üzeri idi (Tablo 1). 28 hastanın 18-i (%64.2) vaginal doğum yapmiş, 4 hasta (%14.3) sezaryen doğum, 6 hasta (%21.5) kombine doğum yapmıştır. Hastaların ortalama yaşı 42.8 ± 1.4 (aralık: 30–70), doğum sayısı 2.3. ± 0.1 (0–3), ortalama BMI 27.2 ± 0.4 (22-31) idi. 28 hastadan 26-sında (92.8%) sonuçtan memnun kalındığı ve önemli bir iyileşme olduğu bildirilmişken, 2 (7.2%) hastada vajinal lazer tedavisine yanıt verilememiş ve hastanın beklediği sonuç olmadığı söylenmiştir
Sonuç: Stress üriner inkontinans hastaların yaşam kalitesinin düşmesine neden olan bir sağlık problemidir. Stress üriner inkontinansda vajinal lazer tedavisi son dönemlerde önemli yer almaktadır. CO2 lazer ışınının dokuya olan termal etkisi fibroblastlarının inflamatuar iyileşmesinin başlatarak de novo kollajen ve elastin sentezini uyandırır ve bu da daha kalın bir vajinal epitelin, daha büyük çaplı epitel hücrelerinin oluşmasına yol açar. Tam kurs CO2 lazer terapisini tamamlayan hastalarda büyük oranda iyileşme sonucu alınmıştır.
References
- Rovner, E. S., & Wein, A. J. (2004). Treatment options for stress urinary incontinence. Reviews in urology, 6 (Suppl 3), S29.
- Moroni, R. M., Magnani, P. S., Haddad, J. M., Castro, R. D. A., & Brito, L. G. O. (2016). Conservative treatment of stress urinary incontinence: a systematic review with meta-analysis of randomized controlled trials. Revista Brasileira de Ginecologia e Obstetrícia, 38(2), 97-111.
- Ruffolo, A. F., Braga, A., Torella, M., Frigerio, M., Cimmino, C., De Rosa, A. & Serati, M. (2022). Vaginal laser therapy for female stress urinary incontinence: New solutions for a well-known issue-A concise review. Medicina, 58(4), 512.
- Conté, C., Jauffret, T., Vieillefosse, S., Hermieu, J. F., & Deffieux, X. (2017). Laser procedure for female urinary stress incontinence: a review of the literature. Progrès en urologie, 27(17), 1076-1083.
- Ogrinc, U. B., Senčar, S., & Lenasi, H. (2015). Novel minimally invasive laser treatment of urinary incontinence in women. Lasers in surgery and medicine, 47(9), 689-697.
- Committee Opinion No. 603: Evaluation of uncomplicated stress urinary incontinence in women before surgical treatment. Obstet Gynecol. 2014 Jun; 123(6):1403-1407.
- Behnia-Willison, Fariba, et al. "Fractional CO2 laser for treatment of stress urinary incontinence." European Journal of Obstetrics & Gynecology and Reproductive Biology: X 1 (2019): 100004.
- Hafidh, Bandr, et al. "CO2 laser therapy for management of stress urinary incontinence in women: a systematic review and meta-analysis." Therapeutic Advances in Urology 15 (2023): 17562872231210216.
- Menachem, Alcalay, et al. "The effect of vaginal CO2 laser treatment on stress urinary incontinence symptoms." Alma Surgical (2016).
- Nygaard I, Barber MD, Burgio KL, Kenton K, Meikle S, Schaffer J, Spino C, Whitehead WE, Wu J, Brody DJ., Pelvic Floor Disorders Network. Prevalence of symptomatic pelvic floor disorders in US women. JAMA. 2008 Sep 17;300(11):1311-6.
- Long, Cheng-Yu, et al. "The clinical effects of pixel CO2 laser on bladder neck and stress urinary incontinence." Journal of Clinical Medicine 11.17 (2022): 4971.
- Tania Lugo; John Riggs. Stress Incontinence. Last Update: June 26, 2023.
- Dabaja, Hanin, et al. "The safety and efficacy of CO 2 laser in the treatment of stress urinary incontinence." International Urogynecology Journal 31 (2020): 1691-1696.
- Rovner ES, Wein AJ. Treatment options for stress urinary incontinence. Rev Urol. 2004; 6 Suppl 3:S, 29-47.
- Nadia A. Ibrahim, Lutfi G. Awazli. "Stress Urinary Incontinence Treatment Using Vaginal Fractional CO2 Laser (10600nm)." Iraqi Journal of Laser 18.2 (2019): 7-13.
- AA Nalewczynska, M Barwijuk, P Kolczewski. Pixel-CO2 laser for the treatment of stress urinary incontinence. - Lasers in Medical Science, Original Article, volume 37, (2022): 1061-1067
- Alcalay, Menachem, et al. "Fractional-pixel CO2 laser treatment in patients with urodynamic stress urinary incontinence: 1-year follow-up." Lasers in Surgery and Medicine 53.7 (2021): 960-967.
- Novara G, Artibani W, Barber MD, et al. Updated systematic review and meta-analysis of the comparative data on colposuspensions, pubovaginal slings, and midurethral tapes in the surgical treatment of female stress urinary incontinence. Eur Urol. Aug 2010; 58 (2):218-238.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Obstetrics and Gynaecology |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | August 25, 2025 |
| Submission Date | March 12, 2025 |
| Acceptance Date | March 27, 2025 |
| Published in Issue | Year 2025Volume: 64 Issue: Özel Sayı: 1 (11. Ulusal Ürojinekoloji Kongresi Bildiri Kitapçığı) |
