A Randomized Controlled Trial of Platelet-Rich Plasma Combined with Fractional CO2 Laser Therapy for Mild and Moderate Stress Urinary Incontinence in Women.

Introduction and hypothesis: This study aimed to evaluate the effectiveness of platelet-rich plasma (PRP) combined with fractional CO₂ laser therapy in women diagnosed with mild or moderate stress urinary incontinence (SUI).

Methods: In this single-center, single-blinded, randomized controlled trial, 69 women diagnosed with mild or moderate SUI were randomly assigned to receive fractional CO₂ laser therapy, PRP injections, or a combination of both treatments (n = 23 per group). Each participant underwent three treatment sessions at 30-day intervals. Outcomes were assessed using the International Consultation on Incontinence Questionnaire-Short Form (ICI-Q-SF), the Incontinence Quality of Life (I-QOL) questionnaire, and a 1-h pad test at baseline and at 1, 3, and 6 months post-treatment. Generalized estimating equations (GEE) were used to analyze repeated measures across groups.

Results: No statistically significant differences in baseline characteristics were observed among the groups (P > 0.05). All groups demonstrated significant post-treatment improvements in ICI-Q-SF scores, I-QOL scores, and 1-h pad weights (P < 0.05). Compared to the fractional CO₂ laser group, the PRP group showed no significant advantage, whereas the combined group exhibited significantly greater improvements at all time points: greater reductions in ICI-Q-SF scores (β = -1.09, -1.30, -1.39; all P < 0.001), higher I-QOL scores (β = 4.39, 4.61, 5.04; all P < 0.001), and greater decreases in pad weights (β = -1.22, -1.48, -1.78; all P < 0.05).

Conclusions: Combined PRP and fractional CO₂ laser therapy significantly improves urinary incontinence symptoms and quality of life compared to either treatment alone, offering a potentially more effective therapeutic option for women diagnosed with mild or moderate SUI.