Laser Treatment for Stress Urinary Incontinence
Laser treatment for stress urinary incontinence works by using thermal energy to remodel the vaginal wall tissue. Collagen remodelling is stimulated and new collagen fibres are synthesised. The vaginal mucosa (inner lining of the vagina) and collagen-rich endopelvic fascia (connective tissue enveloping pelvic organs) become thicker, better vascularised and tightened, providing greater support to the bladder and urethra, thus allowing the possible return of normal continence function.
What does a laser procedure for Stress Urinary Incontinence involve
This procedure is performed through the vagina and ensures quick recovery without the need for analgesics or antibiotics. 2-3 sessions are usually required at monthly intervals at the initial stage, and repeated sessions may be needed. It is important to note that this procedure is experimental for now and requires more studies to validate its use when compared to other treatments.
It is most suited for mild-moderate stress incontinence and results will vary between patients and patients may only be able to see the improvements after some time.
You may experience recurrence of incontinence after this procedure as you age, gain weight or have any conditions which may cause increased abdominal pressure, e.g. chronic cough or constipation.
Are there any alternative treatments for stress urinary incontinence?
Pelvic Floor Exercises
More commonly known as Kegels, these help to strengthen the muscles that control urination.
Midurethral Sling (MUS)
In this surgery, a pelvic sling made of synthetic mesh is placed under a woman’s urethra through a small cut in the vagina wall to keep the urethra closed in cases of SUI and to provide support.
Autologous Fascial Sling
A strap/ribbon made from the patient’s own body tissue, usually grafted from the abdomen or thigh is placed under the urethra to provide support.
An operation to support the bladder neck, which connects the bladder to the urethra to resist pressure. This surgery can be done laparoscopically or open.
The Injection of Bulking Material
The bulking material is injected into the tissue around the urethra using a scope, which supports the urethra and prevents leakage.
HIFEM (High-Intensity Focused Electromagnetic Technology)
In this procedure, the patient sits on a chair/device that utilises focused electromagnetic waves to stimulate the pelvic floor muscles. It is useful for individuals who are unable to isolate their pelvic floor muscles during Kegels.
What can I expect on the day of the procedure?
Your urologist (or a member of their team) will briefly review your history and medications and will discuss the surgery again with you to confirm your consent.
- We normally carry out the procedure under local anaesthetic with a lignocaine anaesthetic jelly.
- You will be in a lithotomy position with the legs up.
- A glass speculum will be placed inside the vagina, and the laser will rotate inside the internal part of the speculum without making contact with the vaginal walls.
- You will feel some heat and discomfort within the vagina, but it should not be painful.
- The procedure will take about 20-30 minutes, depending on the settings.
- You will be able to pass urine, wash and dress yourself after the procedure.
- The doctor or nurse will explain the findings to you.
- The procedure is normally performed on an outpatient basis, so you will be able to go home straight afterwards.
Is the laser procedure painful
This procedure is generally pain-free with minimal discomfort and a warm sensation.
Are there any post-procedure after-effects?
After the procedure, you may experience a mild discomfort and a warm sensation. Although rare, you may also experience mild swelling, which will subside in a few days.
The impact of these after-effects can vary a lot from patient to patient; you should ask your surgeon’s advice about the risks and their impact on you as an individual.
What can I expect when I get home?
- You will experience some vaginal discharge and rare mild bleeding over the first few days after the procedure, thought this is rare.
- You should drink more fluid as you would normally for the first 24 to 48 hours to flush your system through.
- If you develop a fever, severe pain from passing urine, inability to pass urine or worsening bleeding, you should contact us immediately.
- Avoid any strenuous activity on the day of the procedure and avoid any sexual intercourse for at least one week. This is for your comfort only. There are no wounds in the vagina.
- A follow-up appointment may be made for you to discuss any further treatment.