How Long Does Urinary Continence Last After Treatment with Intravaginal CO2 Laser and Microablative Radiofrequency? A Four-Year Follow-up of a Multi-arm Randomized Clinical Trial (LARF-arm3).

Introduction and hypothesis: CO₂ laser (LS) and microablative radiofrequency (RF) are outpatient options for stress urinary incontinence (SUI) treatment. The aim of this study was to evaluate the lasting effects of SUI treatment using intravaginal CO₂ LS and microablative RF.

Methods: This is a long-term follow-up of a prospective double-blind multi-arm randomized controlled trial, involving women with pure or predominant SUI. Participants received three monthly sessions of LS, RF, or were part of a sham control group (SCT) and were followed up, every 6 months, for 48 months to assess continence rates, defined by the composed outcome: no symptoms, negative stress test, and negative 7-day voiding diary.

Results: One hundred and thirty-nine women were eligible and randomized into the three groups. One hundred and fourteen participants concluded the treatment protocol. The women's mean age was 50.4 (± 9.5) years. The results showed that both LS and RF treatments led to a mean duration of urinary continence of 26.7 months and 24.58 months respectively, compared with 8.21 months in the SCT group. No major complications were observed.

Conclusion: Although the continence rates declined over the time, more than 50% of women in perimenopause, with mild to moderate SUI, pure or predominant SUI, remained without complaints of SUI for at least 24 months after LS or RF application sessions, with no major complications reported.