Vaginal Erbium Laser Versus Pelvic Floor Muscle Training for Stress Urinary Incontinence: A Randomised Controlled Trial. - National Genomics Data Center (CNCB-NGDC)

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Vaginal Erbium Laser Versus Pelvic Floor Muscle Training for Stress Urinary Incontinence: A Randomised Controlled Trial.

Ann-Sophie Page, Eline Borowski, Emma Bauters, Susanne Housmans, Frank Van der Aa, Jan Deprest

Author Information

Ann-Sophie Page: Department Obstetrics & Gynaecology, Pelvic Floor Unit, University Hospitals KU Leuven, and Academic Department Development and Regeneration, Cluster Urogenital Surgery UZ Leuven, KU Louvain, Herestraat 49, 3000, Louvain, Belgium. ann-sophie.page@uzleuven.be. ORCID
Eline Borowski: Department Obstetrics & Gynaecology, Pelvic Floor Unit, University Hospitals KU Leuven, and Academic Department Development and Regeneration, Cluster Urogenital Surgery UZ Leuven, KU Louvain, Herestraat 49, 3000, Louvain, Belgium.
Emma Bauters: Department Obstetrics & Gynaecology, Pelvic Floor Unit, University Hospitals KU Leuven, and Academic Department Development and Regeneration, Cluster Urogenital Surgery UZ Leuven, KU Louvain, Herestraat 49, 3000, Louvain, Belgium.
Susanne Housmans: Department Obstetrics & Gynaecology, Pelvic Floor Unit, University Hospitals KU Leuven, and Academic Department Development and Regeneration, Cluster Urogenital Surgery UZ Leuven, KU Louvain, Herestraat 49, 3000, Louvain, Belgium.
Frank Van der Aa: Department Urology, Pelvic Floor Unit, University Hospitals KU Leuven, and Academic Department Development and Regeneration, Cluster Urogenital Surgery, KU Leuven, Louvain, Belgium.
Jan Deprest: Department Obstetrics & Gynaecology, Pelvic Floor Unit, University Hospitals KU Leuven, and Academic Department Development and Regeneration, Cluster Urogenital Surgery UZ Leuven, KU Louvain, Herestraat 49, 3000, Louvain, Belgium.

PMID: 40080112 DOI: 10.1007/s00192-025-06091-4

INTRODUCTION AND HYPOTHESIS: Current studies on vaginal laser therapy for the management of stress urinary incontinence (SUI) are inconclusive, and many lack comparison with another conservative treatment. Therefore, we compared the efficacy of Er:YAG laser for SUI with that of pelvic floor muscle training (PFMT).
METHODS: Single-centre, randomised controlled trial comparing laser treatment (3-6 applications) with PFMT (9-18 sessions) in women with mild to moderate SUI. Main outcome measures included subjective change in urinary incontinence symptoms by change from baseline to 4 months after randomisation by Urogenital Distress Inventory-6 (UDI-6; primary), adverse events, and other subjective and objective outcomes up to 24 months. A priori sample size calculation for a non-inferiority study resulted in 28 patients per arm. Because of a higher than expected dropout early in the study, we increased our sample size from 56 to 60, without unblinding of the data.
RESULTS: Sixty women were enrolled. Two participants discontinued their allocated treatment (one in each group). At 4 months, mean difference in change in UDI-6 scores was -6.99 (95% CI��=��-22.34; 8.37), demonstrating non-inferiority of laser to PFMT (p��=��0.023). Within groups, most patients improved, yet subjective cure was reached in only a minority (laser: 11% [3 out of 28]; PFMT: 8% [2 out of 26]). The mean number of treatment visits was 4.25 (SD 1.17) in the laser group and 10.04 (SD 6.36) in the PFMT group. There were no subjective or objective inter-group differences. At 24 months, the majority of patients requested additional, yet alternative treatment. There were no serious adverse events at any time point.
CONCLUSIONS: Treatment effect of vaginal laser and PFMT in patients with mild and moderate SUI were comparable, limited and short lasting. No adverse events were reported.

Er:YAG Non-ablative laser Pelvic floor muscle training Physiotherapy Stress urinary incontinence

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