ISSN: 2474-9230
Authors: Behnia-Willison F*, Nguyen TTT, Krneta S, McPhail C, Bahadori S, Willison N, Aryan P, Lam A and Paraiso MFR
Background: Urge urinary incontinence (UUI) is the involuntary loss of urine associated with urgency, frequency, and nocturia. Current management involves behavioural therapies, which can be time-consuming and costly to the patient, and medications, which can have side effects. Fractional micro-ablative CO2 laser (FxCO2) and platelet-rich plasma (PRP) are two novel approaches that may offer symptomatic relief for women with UUI. Objectives: To evaluate the feasibility, safety, and efficacy of FxCO2 vaginal laser treatment and PRP in women with refractory UUI with urinary function and sexual function as secondary outcome measures. Study Design: This was a single-centre prospective cohort study. Participants with UUI underwent three treatments of transvaginal FxCO2 laser and PRP, administered at 4–6-week intervals. Outcomes were assessed with the Australian Pelvic Floor Questionnaire (APFQ) at baseline (T1), 3-6 months (T2), and ≥12 months follow-up (T3). The 12-month follow up data were obtained by face-to-face visit or follow up telephone call. The primary outcome was change in UUI symptoms. Secondary outcomes were related to overall bladder function and sexual function. Outcomes were assessed using Wilcoxon signed-rank test. Results: In this study, 121 participants underwent treatment with FxCO2 laser and PRP for UUI. There was a significant reduction in the average severity of all self-reported measures of primary and secondary outcomes from T1 to T2 (p<0.02). Improvements in all bladder function outcomes remained statistically at T3 (p<0.04). There were no adverse events in this cohort. Conclusion: This study suggests that FxCO2 laser with PRP appears to be a safe, feasible, and effective treatment for UUI, bladder function, and sexual function. FxCO2 laser and PRP may have a role as an alternative therapy for severe and refractory UUI.
Keywords: Urge Urinary Incontinence; Fractional Carbon Dioxide Vaginal Laser Therapy; Platelet Rich Plasma; Bladder Function; Urinary Incontinence; Urinary Urgency
