Predictive factors for the efficacy of Er:YAG laser treatment of urinary incontinence

Objectives: To determine the efficacy and predictive factors for the success of Er:YAG laser treatment in patients with urinary incontinence (UI). Methods: Eighty-two patients with UI were treated by Er:YAG laser in this cohort study. The patients were evaluated by ICIQ-SF and KHQ-UI before and after the procedure. Improvement was categorized as: none (0-25%), mild (26-50%), moderate (51-75%), or high (76-100%). The duration of the treatment effect was evaluated at follow-up in relation to maximum improvement time (MIT) and total improvement time (TIT). Results: Forty-two patients were determined to have SUI and 40 patients MUI. The mean ISIQ-SF and KHQ-UI scores significantly improved after the procedure (p < 0.0001). The SUI patients responded to the laser treatment significantly better (p < 0.008). Younger women had significantly better results (p < 0.008), while premenopausal women (p < 0.032) and women in the early postmenopausal years (p < 0.032) also saw a positive response to the Er:YAG laser treatment. Women with a lower BMI had greater improvement (p < 0.011). The total laser energy expenditure during the sessions may also be a predictive parameter for the success of Er:YAG laser treatment of UI (p = 0.059). MIT and TIT were significantly longer among the patients in the high-improvement group. Conclusion: Er:YAG laser treatment of the symptoms of UI, especially SUI, is more efficacious and of longer duration for younger, premenopausal or early postmenopausal women with normal BMI.