The Efficacy and Safety of Erbium‐Doped Yttrium Aluminum Garnet Laser Therapy for Stress Urinary Incontinence: A Systematic Review and Meta‐Analysis

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OBJECTIVES: The erbium-doped yttrium aluminum garnet(Er:YAG) laser therapy has recently emerged as a novel treatment for stress urinary incontinence (SUI) in women. The purpose of this meta-analysis was to evaluate the efficacy and safety of Er:YAG laser therapy in the management of SUI. MATERIALS AND METHODS: We conducted a search in the databases MEDLINE, EMBASE, and the Cochrane Library, up to December 2024, to identify randomized controlled trials (RCTs) that mentioned the use of Er:YAG laser therapy for the treatment of SUI. A systematic review and meta-analysis was conducted. RESULTS: The meta-analysis included four publications with a total of 390 patients diagnosed with SUI. Posttreatment analysis revealed statistically significant improvements in the Er:YAG laser therapy group for the 1-h pad test (mean difference [MD]: -10.42; 95% confidence interval [CI], -17.32 to -3.53; p = 0.003) and the number of subjective cures as assessed by the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) (odds ratio [OR]; 6.21, 95% CI; 1.55-24.84, p = 0.01). However, no significant differences were observed in the change of ICIQ-SF scores (MD: -0.15; 95% CI, -0.77 to 1.07; p = 0.75) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) scores (MD: 0.81; 95% CI, -0.24 to 1.85; p = 0.13). In terms of comfort, pain visual analog score (VAS) was higher in the laser therapy versus sham therapy following both treatment sessions (The pain VAS after session one (MD; 3.72, 95% CI; 3.24-419, p < 0.00001). The pain VAS after session two(MD; 2.64, 95% CI; 2.12-3.15, p < 0.00001). Regarding adverse events, there were no statistically significant differences between the Er:YAG laser group and the sham group in terms of increased vaginal discharge (OR; 4.64, 95% CI; 0.27-78.30, p = 0.29), vaginal discomfort (OR; 1.31, 95% CI; 0.62-2.73, p = 0.48), and suspected urinary tract infection (UTI) (OR; 3.44, 95% CI; 0.57-20.58, p = 0.18). CONCLUSIONS: Our meta-analysis indicates that the Er:YAG laser appears to be a safe and effective treatment option for SUI.