Er:YAG laser treatment for genitourinary disorders
Objective. To determine the efficacy and safety of Er:YAG laser in the treatment of genitourinary disorders, such as stress urinary incontinence, mixed urinary incontinence, vaginal relaxation syndrome, grade I-II pelvic organ prolapse, and vulvovaginal atrophy.Dobrokhotova Yu.E., Ilyina I.Yu., Venediktova M.G., Morozova K.V., Suvorova V.A., Zalesskaya S.A.
Subjects and methods. The investigation included 65 patients with varying degrees of genitourinary disorders. Their mean age was 44±4.1 years. During the investigation, the patients were surveyed using the specialized questionnaires: the Pelvic Floor Distress Disorders Inventory (PFDI-20) and the Female Sexual Function Index (FSFI) before treatment and at each treatment session. At each visit, the strength of pelvic floor muscles was measured using the PMTx system with biological feedback. The Q-tip test was used to assess the mobility of the urethra and bladder neck. The patients underwent ultrasound examination of the vaginal walls and sonoelastography before and after treatment. All the patients in the study group received erbium laser IncontiLase and IntimaLase treatments using the Fotona Smooth technology on the SP Spectro unit (Fotona, Slovenia) according to the sequence patented by the manufacturer: 4 sessions of laser radiation at an interval of 28 days.
Results. Statistical data processing revealed a statistically significant (Wilcoxon t-test; p < 0.05) reduction in the severity of symptoms of genitourinary disorders and an improvement in quality of life in the patients. In the study group, the incidence of stress urinary incontinence symptoms decreased by 52%. The patients of the study group showed a 36% increase in muscle power as compared to that before treatment. The Q-tip angle reduced by 10.1° at Visit 2, by 12.8° at Visit 3, and by 20.7°at Visit 4 as compared with that at Visit 1. Assessing the changes in PFDI-20 scores showed that the median score was 62.5 [41.7; 85.9] and 22.9 [12.5; 40.6] before and after treatment, respectively. Sonoelastography revealed higher vaginal wall stiffness in 54 (83%) of the 65 patients after treatment. The latter resulted in an improvement in 60 (92%) of the 65 patients.
Conclusion. Based on the data of the clinical study, it can be argued that IncontiLase and IntimaLase procedures using the Fotona Smooth technology are a highly effective and safe treatment for patients with genitourinary disorders.
Keywords
genitourinary disorders
stress urinary incontinence
genital prolapse
Er:YAG laser
Supplementary Materials
- Table 1. The median according to the PFDI-20 questionnaire subsections
- Table 2. Tissue properties after 4 sessions of exposure to laser emission using the elastography method
- Figure 1. PFDI-20 questionnaire indicators’ median dynamics and interquartile range in each treatment session
- Figure 2. FSFI questionnaire indicators’ median dynamics and interquartile range in each treatment session
- Figure 3. Q-tip angle alteration in each treatment session (Student's t-test, p <0.05). Q-tip angle
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Received 31.08.2017
Accepted 22.09.2017
About the Authors
Dobrokhotova Yulia E., MD, professor, head of the Department of Obstetrics and Gynecology, Medical Faculty, N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia. 117997, Russia, Moscow, Ostrovityanova str. 1. Tel.: +79037226399. E-mail: pr.dobrohotova@mail.ruIlyina Irina Yu., MD, professor of the Department of Obstetrics and Gynecology, Medical Faculty, N.I. Pirogov Russian National Research Medical University,
Ministry of Health of Russia. 117997, Russia, Moscow, Ostrovityanova str. 1. Tel.: +79161803303. E-mail: iliyina@mail.ru
Venediktova Marina G., MD, Professor of the Department of Obstetrics and Gynecology, Medical Faculty, N.I. Pirogov Russian National Research Medical University,
Ministry of Health of Russia. 117997, Russia, Moscow, Ostrovityanova str. 1. Tel.: +79255174605. E-mail: marina.venediktova2012@yandex.ru
Morozova Ksenia Vladimirovna, Candidate of Medical Science, Assistant of the Department of Obstetrics and Gynecology, Medical Faculty, N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia. 117997, Russia, Moscow, Ostrovityanova str. 1. Tel.: +79162802018. E-mail: morozovadk@mail.ru
Suvorova Victoria Aleksandrovna, post-graduate student of the Department of Obstetrics and Gynecology, Medical Faculty, N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia. 117997, Russia, Moscow, Ostrovityanova str. 1. Tel.: +79150922900. E-mail: doctor.suvorova@gmail.com
Zalesskaya Sofya Alekseevna, assistant of the Department of Obstetrics and Gynecology, Medical Faculty, N.I. Pirogov Russian National Research Medical University,
Ministry of Health of Russia. 117997, Russia, Moscow, Ostrovityanova str. 1. Tel.: +79670621312. E-mail: sofa.zalesskaya@mail.ru
For citations: Dobrokhotova Yu.E., Ilyina I.Yu., Venediktova M.G., Morozova K.V., Suvorova V.A., Zalesskaya S.A. Er:YAG laser treatment for genitourinary disorders. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (10): 84-91. (in Russian)
https://dx.doi.org/10.18565/aig.2017.10.84-91
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