LASER: is it effective for urinary incontinence and pelvic organ prolapse?

This study reviewed the research available on the effects of laser therapy for urinary incontinence (UI) and pelvic organ prolapse (POP). The main finding was that that laser therapy improved UI, POP, or both.

UI (involuntary leakage of urine) can affect about 30% of women. POP happens when the muscles and tissues supporting the pelvic organs (the uterus, bladder, or rectum) weaken. As a result, one or more of the pelvic organs drop into the vagina. This affects 5-10% of women. Treatments can include pelvic floor training, drugs, or surgery. Each strategy has potential benefits but also potential side effects or symptoms.

Lasers have been introduced as an alternative to surgery or drugs. Manufacturers suggest they may have greater benefits and reduced side effects. Two laser types, erbium-doped yttrium aluminum garnet (ER: YAG) and carbon dioxide (CO₂), are becoming increasingly used. The effectiveness and safety of ER: YAG and CO₂ lasers for the treatment of UI and POP are still under investigation.

This article reviewed 31 other studies that recruited 1530 women with POP, UI, or both POP and UI. Information on patients, how the laser was used, the effectiveness in UI or POP, and any side effects were analyzed.

All studies suggested that laser therapy improved UI, POP, or both. However, there were large differences in how the laser was used and the results that were measured in the individual studies. In 29 studies, the lasers were used in the vagina. In 21 studies, the lasers were used on the vulva. In 2 studies, the laser was used in the urethra (the tube that passes urine from the bladder).

Stress incontinence in UI appeared to be improved by laser when compared to no active treatment. In a single study, after 2-5 laser treatments for POP, 85% of participants reported improvement to grade 0 (no prolapse) or grade 1 (prolapse is more than 1cm above the hymen).

The studies commonly reported mild side effects to treatment such as mild pain, burning at the time of treatment, and vaginal discharge. No major side effects were reported.

The main finding of this review is that laser therapy appears to be an effective treatment for UI and POP. 

Out of the 31 studies included in the review, only 1 was a randomized controlled trial. As such, the effects of the treatments were not compared to a group not receiving the active treatment. Further controlled studies are needed.

If you have questions about the treatment of POP or UI please consult your doctor.