Comparison between VEL therapy and MUS in the treatment of stress and mixed urinary incontinence

Abstract Objective Stress urinary incontinence (SUI) and mixed urinary incontinence (MUI) significantly impact one's quality of life. In Japan, the standard treatments for urinary incontinence involve the use of tension-free vaginal tape (TVT) or transobturator tape (TOT) sling procedures, which include the insertion of synthetic materials. However, issues associated with artificial mesh have prompted the exploration of alternative treatment approaches. Therefore, this study investigates the potential benefits of laser therapy using an erbium-doped yttrium aluminum garnet laser directed into the vagina and urethra, comparing its effects with the conventional treatments. Methods The study enrolled patients who underwent TVT, TOT, or laser therapy (n = 50 in each group). Evaluations were conducted using the 1-hour pad test, the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), and the overactive bladder symptom score both before and 12 months after treatment. In the case of laser therapy, a vaginal probe was inserted after applying a local anesthetic to the vaginal wall, followed by 20 minutes of irradiation at a wavelength of 2940 nm. This laser treatment was administered three times, with two-month intervals between sessions. Results Based on the results of the 1-hour pad test and ICIQ-SF, all three groups—TVT, TOT, and laser therapy—demonstrated comparable improvements in SUI symptoms. However, among patients with MUI, some individuals in the TVT and TOT groups experienced exacerbation, whereas those in the laser therapy group generally exhibited improvement. Conclusions This study confirms the efficacy of laser therapy in the treatment of urinary incontinence. It is worth noting that this research is the first to report on the impact of laser therapy on urinary incontinence in Japanese women.