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Introduction: Previous studies have shown that the fractional carbon dioxide (fCO2) vaginal laser improves genitourinary symptoms of menopause. It has been proposed that fCO2 vaginal laser can also treat stress urinary incontinence (SUI) by increasing collagen production. The aim of our study was to evaluate the effect of vaginal fCO2 laser therapy in patient complaining of SUI. Methods: Women over 18 years old with complaints of urogenital symptoms who had been off vaginal estrogen for at least three months were enrolled in this open-label prospective trial. Participants received 3 laser treatments approximately 6 weeks apart. Stress test was performed on patients at each visit. Responses to the Incontinence-Quality of Life (I-QOL), Questionnaire for Urinary Incontinence Diagnosis (QUID), and Female Sexual Function Index (FSFI) were collected at each treatment visit and at 6- month follow-up. Responses to the Patient Global Impression of Improvement (PGI-I) were collected after the first treatment and then at every follow-up visit. ANOVA analysis was used to compare means at each time point. Results: A total of 58 participants were enrolled. Of these, 75.9% (44/58) complained of SUI. Analysis was performed on the total of 30 participants who had undergone three treatments. Sixty-three percent (19/30) were postmenopausal. Mean follow-up time was 7.7 (SD 3.7) months. Baseline stress test was positive in 6 of the 30 patients (20%). Stress test data was available for 12 patients at the 6-month follow-up and was positive in 2 patients (16.7%). No difference was seen in total FSFI, I-QOL, or the QUID-stress sub-score at the 6-month visit. There was a trend towards improvement in the QUID urge sub-score and the QUID-total (p = 0.06). The mean PGI-I scores showed increased improvement after each treatment and at 6- months (p<0.01), Table 1. Conclusion: Our preliminary results of this open label fCO2 vaginal laser show no objective or subjective improvement in SUI after three treatments. Sexual function symptoms also did not significantly decrease after three treatments. However, there was a trend towards improvement in urge symptoms and patients did report global improvement after each treatment. Further data with larger numbers and longer follow-up are needed to confirm these early findings.


The Annual Winter Meeting of the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction, Virtual, February 25-27, 2021.

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