Vaginal Lasers for Treating Stress Urinary Incontinence in Women: An Abridged Cochrane Systematic Review and Meta-Analysis

We assessed the effects of vaginal lasers for treating stress urinary incontinence (SUI) in women. This systematic review and meta-analysis included randomized trials of women with SUI and assessed therapy with vaginal laser vs sham, control, or topical treatments. Nine studies of 689 women with SUI were included. Overall, the data regarding vaginal laser vs sham treatments were uncertain, and few studies assessed outcome beyond 1 year. In the short term, there may be no difference between the number of continent women between women who underwent vaginal laser compared with sham (risk ratio, 1.50; 95% CI, 0.72-3.10; I2 = 81%; n = 196; very low-certainty evidence). Although vaginal lasers may improve patient-reported incontinence measures compared with sham, the point estimate for improvement does not meet the prespecified minimally clinical importance differences (mean difference, -1.42 points; 95% CI, -2.41 to -0.43; I2 = 54%; n = 632; very low-certainty evidence). Only 1 study provided evidence comparing vaginal laser with topical estrogen. There were no major adverse events in any treatment group at any time point. Vaginal lasers may have little to no effect on SUI as measured by both clinical assessment in the short term compared with sham, control, or topical treatments, but the evidence is uncertain. Vaginal lasers may improve patient-reported measures of SUI, but the evidence is uncertain, and the change may not be noticeable to patients. No major adverse events were reported.