Promising impact of platelet rich plasma and carbon dioxide laser for stress urinary incontinence

Abstract

Promising impact of platelet rich plasma and carbon dioxide laser for stress urinary incontinence Fariba Behnia-Willisona,b,c,*, Tran T.T. Nguyena,b,c, Aidan J. Norburyb, Behrang Mohamadic, Stefano Salvatored, Alan Lame a Department of Obstetrics & Gynaecology, Flinders Medical Centre, Adelaide, Australia b Flinders University, Adelaide, Australia c FBW Gynaecology Plus, Adelaide, Australia d IRCCS San Raffaele University, Milan, Italy e Centre for Advanced Reproductive Endosurgery, Sydney, Australia A R T I C L E I N F O Article history: Received 26 May 2019 Received in revised form 17 September 2019 Accepted 14 October 2019 Available online 22 October 2019 Keywords: Stress urinary incontinence Fractional carbon dioxide laser Platelet rich plasma Bladder function Urinary leakage Bladder urgency A B S T R A C T Objectives: To evaluate the safety, feasibility and efficacy of trans-vaginal fractional micro-ablative CO2 laser therapy in combination with platelet rich plasma (PRP) for the treatment of stress urinary incontinence (SUI) in women. Study design: Participants with SUI underwent three sessions of transvaginal CO2 laser and PRP treatment, administered at 4-6-week intervals. Outcomes were assessed using the bladder function section of the Australian Pelvic Floor Questionnaire (APFQ). The primary outcome was changes in the participants’ symptoms of SUI. Secondary outcomes were related to general bladder function. Outcome differences from baseline (T1) to 3 months (T2) and 12 months (T3) were analysed using Wilcoxon signed-rank tests. Subjective verbal scales were used to assess the degree of pain associated with PRP injections and laser treatment. Results: Sixty-two women with SUI were enrolled into this study. There were 66% (41/62) of participants who reported improved SUI symptoms from T1 to T2 (p < 0.001) and at T3, 62% (23/37) of patients reported improved SUI symptoms (p < 0.001). From T1 to T2, all bladder function variables were improved significantly (p < 0.002). At T3, significant improvements (p < 0.03) were maintained for all bladder function variables, except pad usage (p = 0.073). Conclusions: Combining transvaginal fractional CO2 laser with PRP might be a beneficial treatment for SUI. It may have the potential to be a minimally-invasive and low-risk alternative to surgery, with reduced recovery time.