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    Urinary Incontinence, Vaginal Atrophy – Laser Treatment. Advantage

    Since the treatment is done with a non-ablative laser (heats up the targeted tissue without destroying it) and is minimally invasive, it is safe, quick and convenient for the patient:

    • No incisions
    • Painless (topical anesthesia if necessary)
    • Outpatient
    • Quick recovery
    • Simple procedure

     

    Avoids possible complications with surgical methods used in vaginal tightening.  Urinary incontinence laser surgery has made it possible to change and will change the lives of millions of women.  After having undergone incontinence and/or prolapse surgery (both suburethral and classic surgeries = Kelly, MMK, Burch etc.), patients with chronic urinary incontinence benefit from fractional laser treatments.  Repeated sessions of this laser treatment can be indicated to improve and sometimes completely solve the problem without another surgery.
    After treatment, 80% of the patients report no incontinence; 95% of women rate post treatment discomfort during urination between 0-1.  In 95% of cases, an increase in quality of life is obtained.  A moderate increase in vaginal tightening is achieved in 95% of the patients and a strong increase is achieved in 70%.

    Seventy percent of the couples rated the improvement in their relationships as excellent and 97% of the patients who have undergone the procedure were satisfied or very satisfied with the results obtained.

    Usually the results of the treatment can last about a year, since the effect of the laser can diminish progressively which would revert to vaginal relaxation syndrome.

    It is a two-session procedure lasting 20-25 minutes with an interval period of 4-8 weeks between the first and second sessions.  After the treatment, three months are needed for the reorganization and new generation of collagen fibers and to conclude the regeneration.  When the diameter of the vaginal canal exceeds five centimeters it can sometimes necessitate surgery, but when the diameter is equal to or less than 5 cm a gynecological laser can contract the vaginal muscles achieving a decrease of one cm in diameter for each session.  This procedure can be repeated as many times as necessary.  It has a great advantage over pharmacological treatments that are associated with a high degree of side effects.

    Patients who do not experience an improvement in vaginal dryness with estrogen therapy and/or moisturizers should consider fractional laser treatment.  Gaspar A. research demonstrates that laser treatment compared to hormone replacement therapy offers significantly greater improvement in maturation and offers a longer duration.  Similarly, research conducted by Gambacciani M. on dryness, dyspareunia and vaginal atrophy found that laser treatment is significantly better than hormonal treatment.  The laser poses minimal risk and eliminates the possibility of tissue necrosis by being non-ablative, without cutting, abrasions or bleeding.  These characteristics make laser an ideal instrument for the thermal treatment of vaginal walls.
    Both techniques, laser and hyaluronic acid, can be performed separately or together in the same session depending on the needs of the patient.  The results can last several years, but will depend on the baseline condition of each patient.

    Bezmenko assessed a 56% average thickening of the vaginal walls 6-months after two treatments with the genitourinary laser.  The same group used magnetic resonance measurements to demonstrate contraction of the vaginal canal cross-section, finding also significant contraction of the vaginal canal after laser use.
    According to Sencan, 95% of patients had a reduction in their prolapse levels by at least one degree, 44% had two degrees and 13% had a reduction of 3 degrees.  During a 15-month follow up, 85% of patients had a degree 0 or 1 of prolapse and the remaining 15% of patients had grade II.

    Several clinical studies (Journal of Laser and Health Academy, 2012) demonstrate the effectiveness of the treatment:

    • 95% of the patients showed an increase in vaginal wall thickness.
    • 89% reported improved sexual intercourse.
    • 83% of prolapse cases showed an improvement.
    • 90% showed an improvement in urinary incontinence.

     

    Concha Escriva performs two biopsies 60 days post-laser treatment and shows an enlarged epithelium.  It is an activated epithelium, in which the cells display prominent nuclei and with vacuolization of the cytoplasm.
    The thickness of the vaginal epithelium before treatment was 38 microns, and after treatment was 166 microns. The difference is very relevant.

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