CO2 Laser and radiofrequency compared to a sham control group in treatment of stress urinary incontinence (LARF study arm 3). A randomized controlled trial

Author(s)

Seki, Ana Silvia ; Bianchi-Ferraro, Ana Maria H. M. ; Fonseca, Eliana S. M. ; Sartori, Marair G. F. ; Girao, Manoel J. B. C. ; Jarmy-Di Bella, Zsuzsanna I. K.

• Document type: Journal article
• Source: INTERNATIONAL UROGYNECOLOGY JOURNAL; v. N/A, p. 8-pg., 2022-03-07.

Abstract

Introduction and hypothesis Female stress urinary incontinence (SUI) is a prevalent condition, and conservative treatment options are needed. Were evaluated CO2 laser and radiofrequency as treatment for SUI. Methods One hundred thirty-nine women with SUI were eligible and randomized in a three-arm double-blind randomized controlled trial into radiofrequency (RF), laser (LS) and sham control (SCT) groups, with 3-monthly outpatient treatment sessions. One hundred fourteen women were included, 38 in each group, during a 12-month follow-up. The primary outcomes were: subjective improvement of SUI, evaluated on a Likert scale, and objective cure, which was a composite outcome defined according to negative stress tests, voiding diary and pad test. Questionnaires were also applied. The sample size was calculated to provide 80% power to identify a 20% difference between groups, p < 0.05. Results Subjective improvement and objective cure of SUI were identified respectively in 72.6% and 45.2% in LS and in 61.7% and 44.7% in RF, both significantly higher than the 30.0% and 14.0% in SCT. Considering only mild cases (pad test < 10 g), objective cure was achieved in 66.7% in LS, 63.6% in RF and 22.2% in SCT. Significant reduction in the number of episodes of urinary incontinence was found according to voiding diaries (p = 0.029) and pad weight (p = 0.021). A significant reduction in urgency and urinary loss during sexual intercourse was observed only with LS and RF. Improvement in quality of life was also verified by the I-QoL and ICIQ-SF in favor of the energy-treated groups. Conclusions CO2 laser and radiofrequency are outpatient options for SUI treatment, with no major complications. They had similar results and presented better results than in the sham control group. (AU)

• FAPESP's process: 19/15802-1 - LARF Project: laser and radiofrequency for genital atrophy and urinary incontinence treatment
• Grantee: Marair Gracio Ferreira Sartori
• Support Opportunities: Regular Research Grants