Work

Fractional carbon dioxide vaginal laser for the treatment of urinary symptoms: 36-month results

Year: 2026

Type: article

Abstract: Purpose Fractional carbon dioxide laser (fCO2) has been proposed to treat vulvo-vaginal symptoms of genitourinary syndrome of menopause (GSM), and urinary symptoms including urgency, urgency urinary incontinence (UUI), and stress urinary incontinence (SUI). The thermal effects of the fCO2 laser can lead to collagen remodeling, improving vaginal tissue integrity and urethral support. Our study aimed to measure the impact of vaginal fCO2 laser therapy on a general group of women with vulvo-vaginal and urinary symptoms. Methods Women with complaints of urogenital symptoms were enrolled in an open-label prospective trial. Participants underwent three laser treatments, each six weeks apart. Follow-up consisted of 6, 12, 24 and 36-month visits during which cough stress test was performed and questionnaires were administered. ANOVA analysis was used to compare means at each time point. Results 100 women, 73 menopausal, with an average age of 55 were enrolled in the study. The PGI-I at 16 weeks showed 32/81 (39.5%) patients were markedly or moderately better, 20/74 (27%) at 6 months, 22/60 (36.7%) at 1 year, 17/44 (38.6%) at 24 months and 17/38 (44.7%) at 36 months. Patients reported significant improvement on the QUID-UUI at all visits out to 36 months, but no significant decrease in UUI episodes were noted. OABq symptom score and Quality-of-life significantly improved at each follow-up visit. For those reporting SUI at baseline, SUI leaks were significantly reduced at each follow-up timepoint compared to baseline (p = 0.0066) as were QUID-SUI scores (p = 0.0002). Significant reduction in the incidence of vulvar dryness (p = 0.0005), vulvar burning (p = 0.0061) and vulvar pain during intercourse (p = 0.0258) were seen. Conclusion Our results show that vaginal fCO2 laser therapy improves vulvo-vaginal symptoms and urinary symptoms. The urge / OAB patients reported significant durable improvement to 36 months. PGI-I finds 44.7% of women markedly or moderately better at 36 months. More research is needed for long-term results.

Source: International Urology and Nephrology

DOI: 10.1007/s11255-026-05314-x