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Intraurethral Erbium:YAG laser for the management of urinary symptoms of genitourinary syndrome of menopause: A pilot study.
Lasers Surg Med. 2018 10; 50(8):802-807.LS

Abstract

OBJECTIVES

Genitourinary syndrome of menopause (GSM) combines the conditions of vulvovaginal atrophy (VVA) and urinary tract dysfunction, which is a result of urethral atrophy. There are several treatment methods available for the management of vulvovaginal symptoms of GSM, whereas urinary tract dysfunction often remains overlooked and undertreated. The objective of this pilot study was to assess the safety and efficacy of intraurethral Er:YAG laser treatment of urinary symptoms of GSM.

PATIENTS AND METHODS

Patients with diagnosed GSM, having less than 5% of vaginal superficial cells in the cytology, vaginal pH higher than 5, with urinary symptoms of GSM (dysuria, frequency, urgency) and impaired continence due to urethral atrophy, received two sessions of intraurethral Er:YAG laser with a 3-week interval in-between the sessions. Laser energy was delivered in non-ablative way using Erbium SMOOTH™ mode technology and a 4-mm thick cannula. Therapeutic efficacy was determined using ICIQ-SF, the 1-hour pad test and VAS scores. Occurrence of adverse effects was followed at every visit. Follow ups (FU) were at 3 and 6 months.

RESULTS

29 female patients fulfilling the inclusion criteria were included in this pilot study and received two sessions of the intraurethral non-ablative Erbium SMOOTH™ laser therapy. Significant improvement was observed in all measured parameters at both FU. ICIQ-SF improved by an average of 64% at 3 months FU and by 40% at 6 months. The 1-hour pad test showed a reduction of the quantity of leaked urine by 59% at 3 months FU and by 42% at 6 months FU. All urinary symptoms of GSM improved. Dysuria dropped to 13% and 31% of baseline values at three and 6 months respectively, urinary urgency dropped to 23% and 47% and frequency dropped to 22% and 43% after 3 and 6 months, respectively. Adverse effects were mild and transient.

CONCLUSIONS

Our findings suggest that intraurethral Er:YAG laser is an efficacious and safe modality for treatment of urinary symptoms of GSM, however, prospective, randomized, and controlled trials with larger number of patients are needed to better assess the long-term effect of this novel procedure. Lasers Surg. Med. 50:802-807, 2018. © 2018 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.

Authors+Show Affiliations

Espacio Gaspar Clinic, Olascoaga 881, 5500, Mendoza, Argentina. Uroclinica Mendoza, Paso de Los Andes, 5500, Mendoza, Argentina.Espacio Gaspar Clinic, Olascoaga 881, 5500, Mendoza, Argentina.Uroclinica Mendoza, Paso de Los Andes, 5500, Mendoza, Argentina.Espacio Gaspar Clinic, Olascoaga 881, 5500, Mendoza, Argentina.Espacio Gaspar Clinic, Olascoaga 881, 5500, Mendoza, Argentina.Fotona d.o.o., Stegne 7, SI-1000, Ljubljana, Slovenia.Fotona d.o.o., Stegne 7, SI-1000, Ljubljana, Slovenia.

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

29667744

Citation

Gaspar, Adrian, et al. "Intraurethral Erbium:YAG Laser for the Management of Urinary Symptoms of Genitourinary Syndrome of Menopause: a Pilot Study." Lasers in Surgery and Medicine, vol. 50, no. 8, 2018, pp. 802-807.
Gaspar A, Maestri S, Silva J, et al. Intraurethral Erbium:YAG laser for the management of urinary symptoms of genitourinary syndrome of menopause: A pilot study. Lasers Surg Med. 2018;50(8):802-807.
Gaspar, A., Maestri, S., Silva, J., Brandi, H., Luque, D., Koron, N., & Vižintin, Z. (2018). Intraurethral Erbium:YAG laser for the management of urinary symptoms of genitourinary syndrome of menopause: A pilot study. Lasers in Surgery and Medicine, 50(8), 802-807. https://doi.org/10.1002/lsm.22826
Gaspar A, et al. Intraurethral Erbium:YAG Laser for the Management of Urinary Symptoms of Genitourinary Syndrome of Menopause: a Pilot Study. Lasers Surg Med. 2018;50(8):802-807. PubMed PMID: 29667744.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intraurethral Erbium:YAG laser for the management of urinary symptoms of genitourinary syndrome of menopause: A pilot study. AU - Gaspar,Adrian, AU - Maestri,Sandra, AU - Silva,Joaquin, AU - Brandi,Hugo, AU - Luque,Daniel, AU - Koron,Neža, AU - Vižintin,Zdenko, Y1 - 2018/04/18/ PY - 2018/03/28/accepted PY - 2018/4/19/pubmed PY - 2019/8/6/medline PY - 2018/4/19/entrez KW - Erbium SMOOTH™ laser KW - genitourinary syndrome of menopause KW - impaired continence KW - intraurethral KW - urethral atrophy SP - 802 EP - 807 JF - Lasers in surgery and medicine JO - Lasers Surg Med VL - 50 IS - 8 N2 - OBJECTIVES: Genitourinary syndrome of menopause (GSM) combines the conditions of vulvovaginal atrophy (VVA) and urinary tract dysfunction, which is a result of urethral atrophy. There are several treatment methods available for the management of vulvovaginal symptoms of GSM, whereas urinary tract dysfunction often remains overlooked and undertreated. The objective of this pilot study was to assess the safety and efficacy of intraurethral Er:YAG laser treatment of urinary symptoms of GSM. PATIENTS AND METHODS: Patients with diagnosed GSM, having less than 5% of vaginal superficial cells in the cytology, vaginal pH higher than 5, with urinary symptoms of GSM (dysuria, frequency, urgency) and impaired continence due to urethral atrophy, received two sessions of intraurethral Er:YAG laser with a 3-week interval in-between the sessions. Laser energy was delivered in non-ablative way using Erbium SMOOTH™ mode technology and a 4-mm thick cannula. Therapeutic efficacy was determined using ICIQ-SF, the 1-hour pad test and VAS scores. Occurrence of adverse effects was followed at every visit. Follow ups (FU) were at 3 and 6 months. RESULTS: 29 female patients fulfilling the inclusion criteria were included in this pilot study and received two sessions of the intraurethral non-ablative Erbium SMOOTH™ laser therapy. Significant improvement was observed in all measured parameters at both FU. ICIQ-SF improved by an average of 64% at 3 months FU and by 40% at 6 months. The 1-hour pad test showed a reduction of the quantity of leaked urine by 59% at 3 months FU and by 42% at 6 months FU. All urinary symptoms of GSM improved. Dysuria dropped to 13% and 31% of baseline values at three and 6 months respectively, urinary urgency dropped to 23% and 47% and frequency dropped to 22% and 43% after 3 and 6 months, respectively. Adverse effects were mild and transient. CONCLUSIONS: Our findings suggest that intraurethral Er:YAG laser is an efficacious and safe modality for treatment of urinary symptoms of GSM, however, prospective, randomized, and controlled trials with larger number of patients are needed to better assess the long-term effect of this novel procedure. Lasers Surg. Med. 50:802-807, 2018. © 2018 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc. SN - 1096-9101 UR - https://www.unboundmedicine.com/medline/citation/29667744/Intraurethral_Erbium:YAG_laser_for_the_management_of_urinary_symptoms_of_genitourinary_syndrome_of_menopause:_A_pilot_study_ L2 - https://doi.org/10.1002/lsm.22826 DB - PRIME DP - Unbound Medicine ER -