Current Treatment of Stress Urinary Incontinence by Bulking Agents and Laser Therapy—An Update
Stress urinary incontinence (SUI) affects around 20% of women. In addition to the established suburethral sling insertion, two less invasive approaches are of interest today: urethral bulking agents and vaginal laser therapy. This review discusses articles through December 2023 identified by a PubMe...
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MDPI AG
2024-02-01
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author | Michal Sikora Marianne Gamper Irena Zivanovic Julia Münst Helena Bischofberger Jacek Kociszewski Volker Viereck |
author_facet | Michal Sikora Marianne Gamper Irena Zivanovic Julia Münst Helena Bischofberger Jacek Kociszewski Volker Viereck |
author_sort | Michal Sikora |
collection | DOAJ |
description | Stress urinary incontinence (SUI) affects around 20% of women. In addition to the established suburethral sling insertion, two less invasive approaches are of interest today: urethral bulking agents and vaginal laser therapy. This review discusses articles through December 2023 identified by a PubMed literature search using the keywords “incontinence” and “bulking” or “laser”. Although the two approaches are less effective than sling insertions, there are specific conditions in which one or the other technique is more advantageous. Injecting bulking agents into the urethra only takes some minutes and works without general anesthesia. The method is particularly suited for elderly, frail, or obese patients with multiple comorbidities, but is also applicable for all patients and in combination with other therapies. Generally, the safety profile is good but differs between bulking materials. Two laser types—the Erbium:YAG laser with SMOOTH-mode and the fractional ablative CO<sub>2</sub> laser—deliver heat into the tissue to induce tissue tightening and regeneration. Intravaginal laser therapy improves mild to moderate SUI, while studies describe how intraurethral laser therapy is also beneficial for severe SUI. Young women between childbirths, as well as postmenopausal women, may benefit from laser therapy. The method is safe, can be performed on an outpatient basis, and does not require any artificial material. |
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language | English |
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spelling | doaj.art-9effc2f519fa48dd8712114f57b50a792024-03-12T16:48:14ZengMDPI AGJournal of Clinical Medicine2077-03832024-02-01135137710.3390/jcm13051377Current Treatment of Stress Urinary Incontinence by Bulking Agents and Laser Therapy—An UpdateMichal Sikora0Marianne Gamper1Irena Zivanovic2Julia Münst3Helena Bischofberger4Jacek Kociszewski5Volker Viereck6Department of Gynecology and Obstetrics, Spital Thurgau Frauenfeld, 8501 Frauenfeld, SwitzerlandDepartment of Gynecology and Obstetrics, Spital Thurgau Frauenfeld, 8501 Frauenfeld, SwitzerlandDepartment of Gynecology and Obstetrics, Spital Thurgau Frauenfeld, 8501 Frauenfeld, SwitzerlandDepartment of Gynecology and Obstetrics, Spital Thurgau Frauenfeld, 8501 Frauenfeld, SwitzerlandDepartment of Gynecology and Obstetrics, Spital Thurgau Frauenfeld, 8501 Frauenfeld, SwitzerlandDepartment of Gynecology and Obstetrics, Evangelisches Krankenhaus Hagen-Haspe, 58135 Hagen, GermanyDepartment of Gynecology and Obstetrics, Spital Thurgau Frauenfeld, 8501 Frauenfeld, SwitzerlandStress urinary incontinence (SUI) affects around 20% of women. In addition to the established suburethral sling insertion, two less invasive approaches are of interest today: urethral bulking agents and vaginal laser therapy. This review discusses articles through December 2023 identified by a PubMed literature search using the keywords “incontinence” and “bulking” or “laser”. Although the two approaches are less effective than sling insertions, there are specific conditions in which one or the other technique is more advantageous. Injecting bulking agents into the urethra only takes some minutes and works without general anesthesia. The method is particularly suited for elderly, frail, or obese patients with multiple comorbidities, but is also applicable for all patients and in combination with other therapies. Generally, the safety profile is good but differs between bulking materials. Two laser types—the Erbium:YAG laser with SMOOTH-mode and the fractional ablative CO<sub>2</sub> laser—deliver heat into the tissue to induce tissue tightening and regeneration. Intravaginal laser therapy improves mild to moderate SUI, while studies describe how intraurethral laser therapy is also beneficial for severe SUI. Young women between childbirths, as well as postmenopausal women, may benefit from laser therapy. The method is safe, can be performed on an outpatient basis, and does not require any artificial material.https://www.mdpi.com/2077-0383/13/5/1377stress urinary incontinencebulking agentBulkamid<sup>®</sup>Macroplastique<sup>®</sup>Urolastic<sup>®</sup>Erbium:YAG laser |
spellingShingle | Michal Sikora Marianne Gamper Irena Zivanovic Julia Münst Helena Bischofberger Jacek Kociszewski Volker Viereck Current Treatment of Stress Urinary Incontinence by Bulking Agents and Laser Therapy—An Update Journal of Clinical Medicine stress urinary incontinence bulking agent Bulkamid<sup>®</sup> Macroplastique<sup>®</sup> Urolastic<sup>®</sup> Erbium:YAG laser |
title | Current Treatment of Stress Urinary Incontinence by Bulking Agents and Laser Therapy—An Update |
title_full | Current Treatment of Stress Urinary Incontinence by Bulking Agents and Laser Therapy—An Update |
title_fullStr | Current Treatment of Stress Urinary Incontinence by Bulking Agents and Laser Therapy—An Update |
title_full_unstemmed | Current Treatment of Stress Urinary Incontinence by Bulking Agents and Laser Therapy—An Update |
title_short | Current Treatment of Stress Urinary Incontinence by Bulking Agents and Laser Therapy—An Update |
title_sort | current treatment of stress urinary incontinence by bulking agents and laser therapy an update |
topic | stress urinary incontinence bulking agent Bulkamid<sup>®</sup> Macroplastique<sup>®</sup> Urolastic<sup>®</sup> Erbium:YAG laser |
url | https://www.mdpi.com/2077-0383/13/5/1377 |
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