POTENTIAL OF NON-INVASIVE ER:YAG SMOOTH® LASER AND HIGH-INTENSITY TESLA MAGNETIC STIMULATION (HITS®) TREATMENT OF URINARY INCONTINENCE IN WOMEN

Problem statement Since 2015 great number of clinical studies have shown the advantages of different energy-based devices (EBD) for the treatment of (stress) urinary incontinence (S(UI) and genitourinary syndrome of menopause (GSM). Most studies have referred to the use of nonablative Er:YAG SMOOTH® laser for the treatment of SUI and mixed urinary incontinence (MUI), and both Er:YAG and CO2 lasers in the treatment of GSM.

Methods and results Head-to-head studies showed that Er:YAG SMOOTH® laser improves urinary incontinence in women as effectively as the tension-free vaginal tape (TVT) and transobturator tape (TOT) procedures. For patients with mixed urinary incontinence (MUI), some in the TVT and TOT groups showed exacerbation. However, all patients in the laser therapy group tended to improve.

Vaginal erbium laser (VEL) safely and effectively improve overactive bladder symptoms score (OABSS) compared to common pharmacotherapies, anticholinergics and β3-adrenoceptor agonists, however through a different mechanism. VEL improves blood flow in the bladder, urethra, and vaginal wall reducing OABSS without adverse effects typical for medication.

The comparative study showed that Er:YAG SMOOTH® delivers an equally significant reduction in SUI, both in hysterectomized and non-hysterectomized patients.

Faraday’s law of magnetic induction, whereby a magnetic field pulse induces electrical activity that depolarizes the nerves and causes selective supramaximal contraction of the pelvic floor muscles. Repeated activation of the terminal motor nerve fibers and the motor end plates will tend to build muscle strength and endurance. High-intensity Tesla magnetic stimulation (HITS™), enables fast and easy strengthening of the pelvic floor muscles without effort. The results suggest a statistically significant reduction in the frequency of urinary leakage in all three types of urinary incontinence (p = 0.001). Magnetic stimulation has a positive impact on reducing the symptoms of urinary incontinence and improving quality of life.

Conclusion The combination of these two techniques may work in a synergistic manner to boost the overall effect of pelvic organ support.