Laser for stress urinary incontinence

The using of a laser for the treatment of urinary incontinence (NM) is one of the most effective means for the treatment of this pathology. According to recent sociological studies, the problem of female urinary incontinence is a serious not only medical, but also a social problem, from which almost half of the women in the world suffer from varying degrees of severity. Despite the fact that the causes of this pathology have not been fully established, the main factors stimulating this problem are:

1) state of pregnancy
2) congenital pathology
3) menopause
4) overweight
5) age-related changes
6) cognitive impairment

Considering comprehensively all the causes of urinary incontinence, most experts agree that one of the links in the pathogenesis of this disease is atrophy or weakening of the tissues of the musculo-ligamentous apparatus of the pelvic floor. It is to restore and increase the tone of the muscles of the vagina that the action of the basic medical techniques designed to treat urinary incontinence in women is directed.

All conservative methods for the treatment of urinary incontinence can be divided into two groups: surgical and minimally invasive. Conservative non-invasive methods of treating this patology include: taking special medications, improving lifestyle, special training of the muscles of the pelvic floor and bladder, electromagnetic stimulation of the muscles of the pelvic floor, etc. Surgical methods of treating urinary incontinence use colsuspension methods or are based on the use of special slings for urinary the bubble. However, the low effectiveness of these methods along with the high probability of side effects, especially during surgical interventions, have led to the fact that laser technologies have been actively used to treat urinary incontinence.

Principles of laser exposure to tissues in the pathology of urinary incontinence in women

The main factor in the treatment of urinary incontinence in women using laser radiation is the stimulation of regenerative processes in tissues with the restoration of normal distribution collagen in them.

Under the influence of laser radiation in the treated tissues, new collagen fibers are regenerated, as a result of which the tissues around the bladder are tightened and become more elastic. Increased tissue elasticity improves muscle support of the urethra, reduces urethral hypermobility, and thus reduces the symptoms of urinary incontinence. In addition, in the process of using a laser for the treatment of urinary incontinence, there is a decrease in vaginal volume due to tissue contraction and the strength and duration of contractions of the pelvic floor muscles are improved. Also, under the influence of a medical laser, the neurohumoral regulation of the vaginal mucosa is significantly restored and the formation of new capillaries occurs, which additionally helps to combat atrophy of the vaginal mucosa.

Types of lasers used for therapy urinary incontinence

The safest and most clinically proven laser treatments for urinary incontinence in women are the use of non-invasive laser systems. These include neodymium laser modules (with a generation wavelength of 1064 and 1320 nm) and Er: YAG-based laser systems operating in non-ablative modes (with a radiation wavelength of 2940 nm). The use of ablation techniques by CO2 lasers is currently extremely limited due to the long rehabilitation period, high pain sensations during the procedure and the risk of side effects. The principle of operation of neodymium and erbium laser systems in the treatment of urinary incontinence is aimed at using the thermal energy of the laser to stimulate the processes of neocollagenesis. Physical processes when using these laser systems are similar to each other, however, it should be noted that 1064nm neodymium radiation penetrates the mucosal tissue as deep as possible (3-4mm) and is more difficult to control. Direct erbium laser radiation, on the contrary, penetrates into tissues by a minimum amount, but heating and stimulation of collagen fiber contraction occurs due to heat transfer between tissues and maintaining optimal tissue temperature to reduce collagen fibers (60-70 degrees Celsius). However, given that in the non-ablatibe mode, erbium radiation is inherently not laser, but superluminescent, the best option for using a laser for the treatment of urinary incontinence is a neodymium laser with a wavelength of 1340 nm. Thus, with the correct use of a laser for urinary incontinence using non-invasive techniques, the attending physician simultaneously achieves several clinical results:

• 1)Strengthening the urethra
  2)Reducing mucosal dryness
  3)Normalization of the functioning of the muscles of the pelvic floor
  4)Compensation of the initial stages of prolapse

Clinical results obtained in Russian and foreign medical centers show that the use of laser technology promises to be the preferred and main solution for most women suffering from urinary incontinence syndrome.