Laser therapy for urinary incontinence and pelvic organ prolapse: a systematic review

Abstract

Background: Laser therapy is now being proposed for the treatment of pelvic organ prolapse (POP) and urinary incontinence (UI).

Objectives: To systematically review the available literature on laser therapy for POP and UI.

Search strategy: PubMed, Web Of Science and Embase were searched for relevant articles, using a three-concept (POP, UI, laser therapy) search engine composed as (concept 1 OR concept 2) AND concept 3.

Selection criteria: Only full-text clinical studies in English.

Data collection and analysis: Data on patient characteristics, laser setting, treatment outcome and adverse events were independently collected by two researchers. There was a lack of methodological uniformity so meta-analysis was not possible and the results are presented narratively.

Main results: Thirty-one studies recruiting 1530 adult women met the inclusion criteria. All studies showed significant improvement either on UI, POP or both; however the heterogeneity of laser settings, application and outcome measures was huge. Only one study was a randomised controlled trial, two studies were controlled cohort studies. All three were on UI and used standardised validated tools. The risk of bias in the randomised controlled trial was low on all seven domains; the controlled studies had a serious risk of bias. No major adverse events were reported, mild pain and burning sensation were the most commonly described adverse events.

Conclusions: All studies on vaginal and/or urethral laser application for POP and UI report improvement, but the quality of studies needs to be improved.

Tweetable abstract: There is weak evidence that laser therapy is effective for urinary incontinence and pelvic organ prolapse #LASER#UI#POP.

Keywords: laser; pelvic organ prolapse; urinary incontinence.