Introduction: According to the International Continencе Society (ICS), urinary incontinence is the involuntary loss of urine that represents a hygienic or social problem to the individual. However, this problem is very heterogeneous presenting variably in the clinic, and having very different pathogenesis behind it. Therefore, the treatment plans for stress, urge, overflow and bypass UIs differ widely. The estimated prevalence of stress urinary incontinence (SUI) in adult women ranges from 4% to 35%. The primary mechanism of SUI is inability to transmit increased intra-abdominal pressure to the urethra.
Materials and Methods: The aim of the research was to review and compare currently available laser treatment options for SUI. We have researched PubMed and PMC databases using keywords: `urinary incontinence`, `stress urinary incontinence`, `laser treatment``. After reviewing the available literature we have selected four articles as being contemporary and the most relevant to the subject.
Results: Currently available first line treatment methods of SUI are behavioural modifications and physical therapy. Second line treatments are surgical. First line methods results depend on the patient`s compliance and age. The surgical option has possible complications of urinary retention, chronic urinary infection, perforation of the urethra during surgery and foreign body reaction to the implant.
Non-ablative laser therapy is a non-invasive, non-compliance dependent new option for treatment. SUI patients have a higher prevalence of defective collagen in the pelvic floor compared to the healthy women without SUI. Therefore, stimulation of collagen proliferation by laser should treat the condition.
Conclusion: CO2 or Er:YAG non-ablative laser methods focus on increasing the temperature of the anterior wall of the vaginal mucosa enough to stimulate synthesis of new collagen fibrils without damaging the epidermis layer, so as to decrease the downtime after the treatment and eliminate the need for anaesthesia during the procedure. The treatment is promising, however, available pilot studies on the matter have several limitations such as small patient population, exclusion criteria that include major risk factor for SUI, short follow-up time, loss of patient population during the follow-up.
