The Efficacy and Safety of Erbium-Doped Yttrium Aluminum Garnet Laser Therapy for Stress Urinary Incontinence: A Systematic Review and Meta-Analysis

IF 2.2 3区医学 Q2 DERMATOLOGY

Lasers in Surgery and Medicine Pub Date : 2025-04-06 DOI:10.1002/lsm.70012

Huilei Yan, Jialei Wang, Yefei Ding, Guanli Huang, Hao Ding, Wei Zhao, Yunbo Ma

{"title":"The Efficacy and Safety of Erbium-Doped Yttrium Aluminum Garnet Laser Therapy for Stress Urinary Incontinence: A Systematic Review and Meta-Analysis","authors":"Huilei Yan, Jialei Wang, Yefei Ding, Guanli Huang, Hao Ding, Wei Zhao, Yunbo Ma","doi":"10.1002/lsm.70012","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objectives</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Materials and Methods</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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; <i>p</i> = 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, <i>p</i> = 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; <i>p</i> = 0.75) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) scores (MD: 0.81; 95% CI, −0.24 to 1.85; <i>p</i> = 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, <i>p</i> < 0.00001). The pain VAS after session two(MD; 2.64, 95% CI; 2.12–3.15, <i>p</i> < 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, <i>p</i> = 0.29), vaginal discomfort (OR; 1.31, 95% CI; 0.62–2.73, <i>p</i> = 0.48), and suspected urinary tract infection (UTI) (OR; 3.44, 95% CI; 0.57–20.58, <i>p</i> = 0.18).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Our meta-analysis indicates that the Er:YAG laser appears to be a safe and effective treatment option for SUI.</p>\n </section>\n </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"57 4","pages":"297-305"},"PeriodicalIF":2.2000,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Lasers in Surgery and Medicine","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/lsm.70012","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"DERMATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

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.

查看原文本刊更多论文

掺铒钇铝石榴石激光治疗压力性尿失禁的疗效和安全性：系统综述和荟萃分析。

目的：掺铒钇铝石榴石（Er:YAG）激光治疗最近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激光治疗SUI的疗效和安全性。材料和方法：我们在MEDLINE、EMBASE和Cochrane图书馆数据库中进行了检索，检索到2024年12月，以确定提到使用Er:YAG激光治疗SUI的随机对照试验（rct）。进行了系统回顾和荟萃分析。结果：荟萃分析包括四篇出版物，共390名诊断为SUI的患者。治疗后分析显示，Er:YAG激光治疗组1小时尿垫试验有统计学显著改善(平均差[MD]: -10.42；95%置信区间[CI]， -17.32 ~ -3.53；p = 0.003)，以及国际失禁咨询问卷简表（ICIQ-SF）评估的主观治愈率(优势比[OR]；6.21, 95% ci；1.55 ~ 24.84, p = 0.01)。但两组间ICIQ-SF评分差异无统计学意义(MD: -0.15；95% CI, -0.77 ~ 1.07；p = 0.75)和盆腔器官脱垂/尿失禁性问卷（PISQ-12）评分(MD: 0.81；95% CI, -0.24 ~ 1.85；p = 0.13)。在舒适度方面，两个治疗阶段后，激光治疗的疼痛视觉模拟评分（VAS）高于假治疗(第一阶段后的疼痛模拟评分(MD；3.72, 95% ci；3.24-419， p结论：我们的荟萃分析表明，Er:YAG激光似乎是SUI安全有效的治疗选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Lasers in Surgery and Medicine 医学-外科

CiteScore

5.40

自引率

12.50%

发文量

119

审稿时长

1 months

期刊介绍： Lasers in Surgery and Medicine publishes the highest quality research and clinical manuscripts in areas relating to the use of lasers in medicine and biology. The journal publishes basic and clinical studies on the therapeutic and diagnostic use of lasers in all the surgical and medical specialties. Contributions regarding clinical trials, new therapeutic techniques or instrumentation, laser biophysics and bioengineering, photobiology and photochemistry, outcomes research, cost-effectiveness, and other aspects of biomedicine are welcome. Using a process of rigorous yet rapid review of submitted manuscripts, findings of high scientific and medical interest are published with a minimum delay.