Impact of Subablative Erb:Yag Laser Applications on Vaginal Resting and Contraction Pressures

Abstract

Aim:The existing data on vaginal laser treatment in pelvic floor dysfunction is encouraging and shows improvement in urinary incontinence (UI) and genital prolapsus symptoms. The aim of this study was to examine the effects of subablative Erb:Yag laser applications for incontinence and vaginal laxity (VL) in terms of changes in vaginal resting and contraction pressures.Methods:This observational, assessor-blind study was conducted in the Women’s Health Clinic of the American Hospital from 2015 to 2017. Data from 176 patients, aged 18 to 55, were analyzed. Each patient received a total of two laser applications, performed six weeks apart. The indications were UI or VL. The pre- and post-treatment vaginal pressures during resting and contraction were measured with a perineometer (Peritron 9300 Perineometer Laborie). All the laser procedures were performed by the same physician, and measurements were carried out by another physician. Laser applications were performed with an Er:YAG laser SMOOTH, Fotona SP Dynamis (Fotona, Slovenia).Results:The age of patients showed a high correlation with the pre-treatment resting and contraction vaginal pressure values (r=-0.23, p=0.002, and r=-024, p=0.002, respectively). After evaluation of all cases, vaginal pressure values measured during rest and contraction showed a significant increase. The correlation coefficient was 0.67 for resting pressure values and 0.72 for contraction pressure values before and after treatment. There was no significant difference between the VL and UI groups in terms of the increase in pre- and posttreatment resting and contraction pressures (p=0.957 and p=0.743, respectively). After analyzing the effect of age, no difference was observed between the VL and UI groups in terms of pressure increase (p=0.515 and p=0.568, respectively). A total of 115 patients, or 61.8% of the cases, stated that they were “satisfied” or “very satisfied” with the treatment.Conclusion:We observed significant improvements in intravaginal resting and contraction pressure values, which we interpreted as an objective strengthening effect of laser treatments on the pelvic floor.

Keywords

• vaginal laser
• perineometer
• pelvic pressure
• vaginal pressure
• vaginal laxity
• urinary incontinence
• pelvic floor