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Introduction and Hypothesis <p>To evaluate the long-term effectiveness of fractional CO<sub>2</sub> laser in the treatment of stress urinary incontinence (SUI), the permanence of symptom control, and additional session requirements over a 2-year follow-up period.</p> Methods <p>This retrospective cohort study included 215 women with clinically diagnosed SUI who underwent a standardized course of fractional CO<sub>2</sub> laser therapy. Assessments were conducted at baseline, 4–6&#xa0;weeks, 1 year, and 2 years. Primary outcome measures included patient-reported satisfaction and Michigan Incontinence Symptom Index (MISI) scores. Secondary outcomes were changes in sexual function determined using the Female Sexual Function Index (FSFI), vaginal symptom severity using the Vaginal Symptom Questionnaire (VSQ), and genital self-image using the Female Genital Self-Image Scale (FGSIS). Data distribution was evaluated using the Shapiro–Wilk test. Repeated measures were analyzed using Friedman or repeated-measures ANOVA, followed by the Dunn or Newman–Keuls post hoc tests. Statistical significance was set at <i>p</i> &lt; 0.05.</p> Results <p>Significant improvement was observed throughout follow-up in all primary and secondary outcomes (<i>p</i> = 0.0001). Satisfaction scores increased significantly at 4–6&#xa0;weeks compared to baseline and still exhibited a high level at 1 year. Although a partial decrease occurred in the second year, values still remained significantly above baseline (from median 2 to 4; <i>p</i> = 0.0001). MISI decreased from 19.51 ± 4.41 at baseline to 1.96 ± 1.38 at 4–6&#xa0;weeks. Although values rose to 6.31 ± 4.01 in the second year, significant improvement compared to baseline was maintained (<i>p</i> = 0.0001). Significant improvement was observed in all FSFI subdomains (including desire, arousal, lubrication, orgasm, satisfaction, pain, and total score) in the early period (<i>p</i> = 0.0001), and despite a slight decrease in the second year, the gains were largely maintained. Similar marked improvements were also observed in VSQ and FGSIS scores, with no return to baseline values despite a partial decline in the second year (<i>p</i> = 0.0001). Supportive additional session requirements were determined in association with subjective worsening in symptoms in the second year in approximately 20% of the participants.</p> Conclusions <p>Fractional CO<sub>2</sub> laser therapy produces significant and clinically important improvement in SUI symptoms, sexual function, vaginal symptoms, sexual function, vaginal comfort, and genital self-image. All effects peak at 4–6&#xa0;weeks, are largely preserved at 1 year, and despite a partial decline in the second year, remain markedly superior to baseline. These findings show that fractional CO<sub>2</sub> laser is an effective, minimally invasive, nonsurgical option in the management of SUI.</p>

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The Long-Term Effectiveness of Fractional CO2 Laser in Stress Urinary Incontinence: A Two-Year Follow-Up Study

  • 期刊论文

  • 发表日期：

    2026年3月21日

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  • Telal Dogruel,
  • Pinar Kadirogullari,
  • Hikmet Can Dogruel,
  • Ozan Dogan,
  • Umran Karabulut Dogan,
  • Erhan Huseyin Comert

摘要

Introduction and Hypothesis

To evaluate the long-term effectiveness of fractional CO2 laser in the treatment of stress urinary incontinence (SUI), the permanence of symptom control, and additional session requirements over a 2-year follow-up period.

Methods

This retrospective cohort study included 215 women with clinically diagnosed SUI who underwent a standardized course of fractional CO2 laser therapy. Assessments were conducted at baseline, 4–6 weeks, 1 year, and 2 years. Primary outcome measures included patient-reported satisfaction and Michigan Incontinence Symptom Index (MISI) scores. Secondary outcomes were changes in sexual function determined using the Female Sexual Function Index (FSFI), vaginal symptom severity using the Vaginal Symptom Questionnaire (VSQ), and genital self-image using the Female Genital Self-Image Scale (FGSIS). Data distribution was evaluated using the Shapiro–Wilk test. Repeated measures were analyzed using Friedman or repeated-measures ANOVA, followed by the Dunn or Newman–Keuls post hoc tests. Statistical significance was set at p < 0.05.

Results

Significant improvement was observed throughout follow-up in all primary and secondary outcomes (p = 0.0001). Satisfaction scores increased significantly at 4–6 weeks compared to baseline and still exhibited a high level at 1 year. Although a partial decrease occurred in the second year, values still remained significantly above baseline (from median 2 to 4; p = 0.0001). MISI decreased from 19.51 ± 4.41 at baseline to 1.96 ± 1.38 at 4–6 weeks. Although values rose to 6.31 ± 4.01 in the second year, significant improvement compared to baseline was maintained (p = 0.0001). Significant improvement was observed in all FSFI subdomains (including desire, arousal, lubrication, orgasm, satisfaction, pain, and total score) in the early period (p = 0.0001), and despite a slight decrease in the second year, the gains were largely maintained. Similar marked improvements were also observed in VSQ and FGSIS scores, with no return to baseline values despite a partial decline in the second year (p = 0.0001). Supportive additional session requirements were determined in association with subjective worsening in symptoms in the second year in approximately 20% of the participants.

Conclusions

Fractional CO2 laser therapy produces significant and clinically important improvement in SUI symptoms, sexual function, vaginal symptoms, sexual function, vaginal comfort, and genital self-image. All effects peak at 4–6 weeks, are largely preserved at 1 year, and despite a partial decline in the second year, remain markedly superior to baseline. These findings show that fractional CO2 laser is an effective, minimally invasive, nonsurgical option in the management of SUI.