Efficacy of Fractional CO2 Laser for the Treatment of Female Stress Urinary Incontinence Grade I
Puckjira Iaocharoen MD*, Orawan Lekskulchai MD*, Chamnan Tanprasertkul MD*
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand ** Urogynecology clinic, Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand *** Center of excellence in Applied Epidemiology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Objective : To study the efficacy of fractional carbon dioxide (CO2) laser for treatment of stress urinary incontinence (SUI)
grade I.
Material and Method: A prospective single arm clinical trial was conducted from December 2015 to February 2016 at
Thammasat University hospital, a tertiary care center in Thailand. Women with SUI grade I were recruited and treated with
fractional CO2 laser for 3 episodes, 4-week interval. Pre and post-treatment SUI symptoms, bladder neck descent (BND) and
the Q-tip test were compared. The study hypothesis was that fractional CO2 laser could improve the anatomical changes of
the vaginal wall under the bladder neck and help strengthen the bladder neck support.
Results : Fifty women of mean age 55.4 years with SUI grade I were recruited. The frequency of SUI grade I and nocturia
decreased significantly after laser treatments. The average of pre-treatment BND was 12.03+7.3 mm and after treatment the
average BND was decreased to 8.6+3.7 mm with statistical significance. The Q-tip test was also significantly decreased. No
women had serious complications from the treatment.
Conclusion : Fractional CO2 laser was well tolerated. It seems to improve the anatomical function of the bladder neck which
may help improve the bladder neck support and mild stress incontinence. However, further well controlled study need to be
done to decrease the confounding factors and biases.
Keywords : Stress urinary incontinence, Fractional CO2 laser, Lower urinary tract symptoms
