Laser

The use of laser technology in gynecology has been known for a long time. However, lasers of the past were very different from today's laser systems. Today, a non-ablative Er:Yag laser with a variety of settings, parameters and hand pieces is used in gynecological procedures. Its performance depends largely on correct settings and a skillfully qualified physician.

Laser treatment is an outpatient procedure conducted without anesthesia. It is completely painless and incisionless, and does not cause any wounds, bleeding or scars.

In gynecology laser is used to treat stress urinary incontinence, vaginal laxity syndrome, pelvic organ prolapses (cystocele, rectocele), herpes infection of the external genitalia, and condyloma. In addition, it is used to perform minor aesthetic surgical procedures of external genitalia, such as the treatment of scars, labia minora correction, and also major surgical procedures, such as the laser reduction of enlarged or asymmetrical labia minora (labioplasty), etc.

In Slovenia, Juna clinic was the first to introduce the treatment of stress urinary incontinence and higher grades of pelvic organ prolapses (cystocele, rectocele).

Laser treatment is based on thermal tissue transformation. It stimulates the regeneration of connective tissue. It causes contraction and restructuring of collagen fibers, as well as reparation and formation of new collagen connective fibers. Vaginal canal tissue becomes firmer, but remains elastic, while the vagina shrinks and the bladder returns to its normal anatomical position. A treated vagina provides a firmer support for the bladder and urethra in their equilibrium anatomical position. In cystocele and rectocele, the pull of deeper connective structures occurs, which further tightens the pelvic floor.

Tightened and improved rugae of the vagina increase friction in sexual intercourse, which is an undisputed factor for a more satisfactory sexual intercourse.

Statistically, the rate of success in laser treatment is comparable in young women as well as in women during menopause. A success in treatment also depends on accurate diagnosis, since laser can be used to treat only the stress component of urinary incontinence.

Laser treatment usually takes 30 minutes. After the treatment, patients can immediately return to their normal everyday activities. However, some precautions are necessary during a two-week post-operation period. Patients are advised to avoid excessive physical strain, sexual intercourse, lifting heavy loads and swimming in stagnant waters.

In stress urinary incontinence the initial laser treatment is usually repeated twice at an interval of six weeks. In pelvic organ prolapses laser treatment requires several repetitions (3-5 times).

Laser treatment of stress urinary incontinence and pelvic organs prolapses (cystocele, rectocele) is non-invasive and pain free.

By the end of March 2013, we had treated 108 female patients using the Er:YAG laser (data as of 27 March 2013) suffering from stress urinary and mixed incontinence. 63% of female patients were diagnosed with stress urinary incontinence, 37% of female patients were diagnosed with mixed urinary incontinence. At a medical examination after 6 months, a reduction in the grade of urinary incontinence was measured in the vast majority of female patients (91.7%). Only in 8.3% of female patients the grade of urinary incontinence remained the same, although they reported a certain improvement. 68% of female patients were completely healed. The level of pain during treatment was minimum (the average rate of 0.6 on the scale of 10), the vast majority of female patients (92.6%) assessed the improvement of their condition as very good or excellent (healed). We have not observed any adverse effect of laser treatment.

The last annual results (June 2014) in laser treatment of 175 female patients with stress urinary incontinence and mixed urinary incontinence are as follows: 62 % of female patients were healed of incontinence, and 92% reported a decreased grade of incontinence. However, following the laser treatment, problems (urge incontinence), may temporarily occur in 10% of cases, but they disappear after a short time.

In November 2015, we published a professional article in an important medical journal http://onlinelibrary.wiley.com/doi/10.1002/lsm.22416/epdf. This is the first professional publication in this field in the world.

Laser treatment of pelvic organ prolapses is non-invasive and painless too. Our annual results (June 2014) of laser treatment of female patients show that at one-year follow-up the cystocele grade decreased on average by 1.6 degree (a one year follow-up of 65 patients with cystocele II-IV grade) .

In March 2017 an article was published on the one-year follow-up of patients following the treatment of cystoceles with a laser http://www.italianjog.com/numeri/mar-vol29-n1/Ogrinc.pdf.


Below you can see an animation of the stress urinary incontinence laser treatment: