Home Female urine incontinence: vaginal erbium laser (VEL) effectiveness and safety
Article
Licensed
Unlicensed Requires Authentication

Female urine incontinence: vaginal erbium laser (VEL) effectiveness and safety

  • David Elia , Marco Gambiacciani , Jean-Marc Ayoubi , Nicolas Berreni , Jean Marc Bohbot , Philippe Descamps , Rene Druckmann , Hugues Geoffrion , François Haab , Niko Heiss EMAIL logo , Nicolas Rygaloff and Eleonora Russo
Published/Copyright: October 30, 2020

Abstract

Urinary incontinence is a common health problem that impacts the quality of life of women at different ages. Its physiopathology is not unequivocal, and it is necessary to consider the stress urinary incontinence (SUI), the overactive bladder syndrome and the mixed incontinence (MUI). According to the type of incontinence, its impact on the quality of life and age of the patients, therapeutic strategies are currently summarized in physiotherapy, surgery and drug treatments. We already know the benefit/risk ratio of each of these strategies. Our objective is to evaluate the potential effectiveness and safety of the VEL, an innovative vaginal laser technique (VEL – Vaginal Erbium Laser, erbium yttrium-aluminum-garnet -Er: YAG) a non-invasive laser proposed as a treatment for SUI, overactive bladder syndrome and MUI. The mechanisms of action of lasers are discussed in general and those of VEL in particular with the description of the Smooth® mode. To do this, we have collected the 21 published studies including the first randomized vs. placebo and two pilot studies of intra-urethral VEL. In conclusion: VEL procedures already have their place between the rehabilitation of the perineal floor and surgery. Further properly sized, randomized studies are needed to evaluate the laser treatments in comparison with other therapies, as well as to assess the duration of the therapeutic effects and the safety of repeated applications.


Corresponding author: Niko Heiss, Vaginal Erbium Laser Academy France, Elsan, Polyclinique Kenval, Nîmes, France, E-mail:

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

References

1. Takahashi, S, Takei, M, Nishizawa, O, Yamaguchi, O, Kato, K, Gotoh, M, et al. Clinical guidelines for female lower urinary tract symptoms. Tokyo: The Neurogenic Bladder Society; 2013:6–168.Search in Google Scholar

2. Hunskaar, S, Burgio, K, Diokno, A, Herzog, AR, Hjälmås, K, Lapitan, MC. Epidemiology and natural history of urinary incontinence in women. Urology 2003;62(4A Suppl):16–23. https://doi.org/10.1016/s0090-4295(03)00755-6.Search in Google Scholar

3. Singh, N, Rashid, M, Bayliss, L, Graham, P. Pelvic floor muscle training for female urinary incontinence: does it work?. Arch Gynecol Obstet 2016;293:1263–9. https://doi.org/10.1007/s00404-015-3965-x.Search in Google Scholar

4. Bø, K. Pelvic floor muscle training in treatment of female stress urinary incontinence, pelvic organ prolapse and sexual dysfunction. World J Urol 2012;30:437–43. https://doi.org/10.1007/s00345-011-0779-8.Search in Google Scholar

5. Ulmsten, U, Henriksson, L, Johnson, P, Varhos, G. An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J 1996;7:81–6. https://doi.org/10.1007/bf01902378.Search in Google Scholar

6. Henriksson, L, Ulmsten, U. A urodynamic evaluation of the effects of abdominal urethrocystopexy and vaginal sling urethroplasty in women with stress incontinence. Am J Obstet Gynecol 1978;131:77–82. https://doi.org/10.1016/0002-9378(78)90478-7.Search in Google Scholar

7. Hilton, P. A clinical and urodynamic study comparing the Stamey bladder neck suspension and suburethral sling procedures in the treatment of genuine stress incontinence. Br J Obstet Gynaecol 1989;96:213–20. https://doi.org/10.1111/j.1471-0528.1989.tb01665.x.Search in Google Scholar PubMed

8. Heneghan, C, Aronson, JK, Goldacre, B, Mahtani, KR, Plüddemann, A, Onakpoya, I. Transvaginal mesh failure: lessons for regulation of implantable devices. BMJ 2017;359:j5515. https://doi.org/10.1136/bmj.j5515.Search in Google Scholar PubMed

9. Abrams, P, Cardozo, L, Fall, M, Griffiths, D, Rosier, P, Ulmsten, U, et al. The standardization of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 2002;21:167–78. https://doi.org/10.1002/nau.10052.Search in Google Scholar PubMed

10. Chapple, CR, Nitti, VW, Khullar, V, Wyndaele, JJ, Herschorn, S, van Kerrebroeck, P, et al. Onset of action of the β3-adrenoceptor agonist, mirabegron, in Phase II and III clinical trials in patients with overactive bladder. World J Urol 2014;32:1565–72. https://doi.org/10.1007/s00345-014-1244-2.Search in Google Scholar PubMed PubMed Central

11. Cetinel, B, Onal, B. Rationale for the use of anticholinergic agents in overactive bladder with regard to central nervous system and cardiovascular system side effects. Korean J Urol 2013;54:806–15. https://doi.org/10.4111/kju.2013.54.12.806.Search in Google Scholar PubMed PubMed Central

12. Yamanishi, Y, Yamanishi, T, Tajima, H, Ikeda, S. Mirabegron or tolterodine for the treatment of overactive bladder in Japan: which drug is more cost-effective as the first-line treatment?. Int J Urol 2018;25:863–70. https://doi.org/10.1111/iju.13764.Search in Google Scholar PubMed

13. Nozawa, Y, Kato, D, Tabuchi, H, Kuroishi, K. Safety and effectiveness of mirabegron in patients with overactive bladder in a real-world clinicals: a Japanese post-marketing study. Low Urin Tract Symptoms 2018;10:122–30. https://doi.org/10.1111/luts.12148.Search in Google Scholar PubMed

14. Wagg, A. Anticholinergics for overactive bladder in frail and medically complex older people: the case for. Drugs Aging 2018;35:777–80. https://doi.org/10.1007/s40266-018-0577-8.Search in Google Scholar PubMed

15. Serati, M, Salvatore, S, Uccella, S, Artibani, W, Novara, G, Cardozo, L, et al. Surgical treatment for female stress urinary incontinence: what is the gold-standard procedure?. Int Urogynecol J Pelvic Floor Dysfunct 2009 Jun;20:619–21. https://doi.org/10.1007/s00192-009-0850-9.Search in Google Scholar PubMed

16. Shaker, H, Alokda, A, Mahmoud, H. The twister laser fiber degradation and tissue ablation capability during 980-nm high power diode laser ablation of the prostate. A randomized study versus the standard side-firing fiber. Laser Med Sci 2012;27:959–63. https://doi.org/10.1007/s10103-011-1017-8.Search in Google Scholar PubMed PubMed Central

17. Brubaker, L, Norton, PA, Albo, ME, Chai, TC, Dandreo, KJ, Lloyd, KL, et al. Adverse events over two years after retropubic or transobturator midurethral sling surgery: findings from the Trial of Midurethral Slings (TOMUS) study. Am J Obstet Gynecol 2011;205:498.e1–498.e6. https://doi.org/10.1016/j.ajog.2011.07.011.Search in Google Scholar PubMed PubMed Central

18. Schimpf, MO, Rahn, DD, Wheeler, TL, Patel, M, White, AB, Orejuela, FJ, et al. Sling surgery for stress urinary incontinence in women: a systematic review and meta-analysis. Am J Obstet Gynecol 2014;211:e71–e27. https://doi.org/10.1016/j.ajog.2014.01.030.Search in Google Scholar PubMed

19. Barsk, D, Gerullis, H, Georgas, E, Bär, A, Lammers, B, Albert, R, et al. Coating of Mesh Grafts for prolapse and urinary incontinence repair with autologous plasma: exploration stage of a surgical innovation. BioMed Res Int 2014;2014, Article ID 296498, 7 pp.10.1155/2014/296498Search in Google Scholar PubMed PubMed Central

20. Abrahamse, H. Regenerative medicine, stem cells, and low-level laser therapy: future directives. Photomed Laser Surg 2012;30:681–2. https://doi.org/10.1089/pho.2012.9881.Search in Google Scholar PubMed

21. Peng, Q, Juzeniene, A, Chen, J, Svaasand, LO, Warloe, T, Karl-Erik, G, et al. Lasers in medicine. Rep Prog Phys 2008;71: 056701. https://doi.org/10.1088/0034-4885/71/5/056701.Search in Google Scholar

22. Gambacciani, M, Levancini, M, Russo, E, Vacca, L, Simoncini, T, Cervigni, M. Long-term effects of vaginal erbium laser in the treatment of genitourinary syndrome of menopause. Climacteric 2018;21:1–5. https://doi.org/10.1080/13697137.2018.1436538.Search in Google Scholar PubMed

23. El-Domyati, M, Abd-El-Raheem, T, Medhat, W, Abdel-Wahab, H, Anwer, MA. Multiple fractional erbium: yttrium aluminum-garnet laser sessions for upper facial rejuvenation: clinical and histological implications and expectations. J Cosmet Dermatol 2014;13:30–7. https://doi.org/10.1111/jocd.12079.Search in Google Scholar PubMed

24. Gaspar, A, Brandi, H, Gomez, V, Luque, D. Efficacy of Erbium: YAG laser treatment compared to topical estriol treatment for symptoms of genitourinary syndrome of menopause. Laser Surg Med 2017 Feb 2016;49:160–8. https://doi.org/10.1002/lsm.22569.Search in Google Scholar PubMed PubMed Central

25. Salvatore, S1, Nappi, RE, Zerbinati, N, Calligaro, A, Ferrero, S, Origoni, M, et al. A 12-week treatment with fractional CO2 laser for vulvovaginal atrophy: a pilot study. Climacteric 2014;17:363–9. https://doi.org/10.3109/13697137.2014.899347.Search in Google Scholar PubMed

26. Okol, ER, Karram, MM. An assessment of the safety and efficacy of a fractional CO2 laser system for the treatment of vulvovaginal atrophy. Menopause 2016;23:1102–7. https://doi.org/10.1097/GME.0000000000000700.Search in Google Scholar PubMed

27. Adrian, G, Hugo, B, Valentin, G, Daniel, L. Efficacy of Erbium: YAG laser treatment compared to topical estriol treatment for symptoms of genitourinary syndrome of menopause. Laser Surg Med 2016;49:160–8. https://doi.org/10.1002/lsm.22569.Search in Google Scholar

28. O’Sullivan, R1, Karantanis, E, Stevermuer, TL, Allen, W, Moore, KH. Definition of mild, moderate and severe incontinence on the 24-hour pad test. BJOG 2004;111:859–62. https://doi.org/10.1111/j.1471-0528.2004.00211.x.Search in Google Scholar PubMed

29. Klarskov, P, Hald, T. Reproducibility and reliability of urinary incontinence assessment with a 60 min test. Scand J Urol Nephrol 1984;18:293–8. https://doi.org/10.3109/00365598409180199.Search in Google Scholar PubMed

30. Rogers, RG, Coates, KW, Kammerer-Doak, D, Khalsa, S, Qualls, C. A short form of the pelvic organ prolapse/urinary incontinence sexual questionnaire (PISQ-12). Int Urogynecol J 2003;14:164–8. https://doi.org/10.1007/s00192-003-1063-2.Search in Google Scholar PubMed

31. Avery, K, Donovan, J, Peters, TJ, Shaw, C, Gotoh, M, Abrams, P. International Consultation on Incontinence Questionnaire (ICIQ): a brief and robust measure for evaluating the symptoms and impact of urinary incontinence. Neurourol Urodyn 2004;23:322–30. https://doi.org/10.1002/nau.20041.Search in Google Scholar PubMed

32. Castro Diaz, D, Robinson, D, Bosch, R, Constantini, E, Cotterill, N, Espuna-Pons, M, et al. Patient-reported outcome assessment. In: Abrams, P, Cardozo, L, Wagg, A, Wein, A, editors. Incontinence, 6th Edition 2017: International Consultation on Incontinence. Tokyo: International Continence Society; 2017:541–99 pp. September 2016.Search in Google Scholar

33. Sandvik, H, Hunskaar, S, Seim, A, Hermstad, R, Vanvik, A, Bratt, H. Validation of a severity index in female urinary incontinence and its implementation in a epidemiological survey. J Epidemiol Community Health 1993;47:497–9. https://doi.org/10.1136/jech.47.6.497.Search in Google Scholar PubMed PubMed Central

34. Matza, LS, Thompson, CL, Krasnow, J, Brewster-Jordan, J, Zyczynski, T, Coyne, KS. Test-retest reliability of four questionnaires for patients with overactive bladder: the overactive bladder questionnaire (OAB-q), patient perception of bladder condition (PPBC), urgency questionnaire (UQ), and the primary OAB symptom questionnaire (POSQ). Neurourol Urodyn 2005;24:215–25. https://doi.org/10.1002/nau.20110.Search in Google Scholar PubMed

35. Coyne, KS, Matza, LS, Kopp, Z, Abrams, P. The validation of the patient perception of bladder condition (PPBC): a single-item global measure for patients with overactive bladder. Eur Urol 2006;49:1079–86. https://doi.org/10.1016/j.eururo.2006.01.007. (PubMed abstract).Search in Google Scholar PubMed

36. Nixon, A1, Colman, S, Sabounjian, L, Sandage, B, Schwiderski, UE, Staskin, DR, et al. A validated patient reported measure of urinary urgency severity in overactive bladder for use in clinical trials. J Urol 2005;174:604–7. https://doi.org/10.1097/01.ju.0000165461.38088.7b.Search in Google Scholar PubMed

37. Homma, Y1, Yoshida, M, Seki, N, Yokoyama, O, Kakizaki, H, Gotoh, M, et al. Symptom assessment tool for overactive bladder syndrome–overactive bladder symptom score. Urology 2006;68:318–23. https://doi.org/10.1016/j.urology.2006.02.042.Search in Google Scholar PubMed

38. Uebersax, JS, Wyman, JF, Shumaker, SA, McClish, DK, Fantl, JA. Short forms to assess life quality and symptom distress for urinary incontinence in women: the incontinence impact questionnaire and the urogenital distress inventory. Continence program for women research group. Neurourol Urodyn 1995;14:131–9. https://doi.org/10.1002/nau.1930140206.Search in Google Scholar PubMed

39. Choi, EP1, Lam, CL, Chin, WY. The incontinence impact questionnaire-7 (IIQ-7) can be applicable to Chinese males and females with lower urinary tract symptoms. Patient 2014;7:403–11. https://doi.org/10.1007/s40271-014-0062-3.Search in Google Scholar PubMed

40. Barber, MD1, Walters, MD, Bump, RC. Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). Am J Obstet Gynecol 2005 Jul;193:103–13. https://doi.org/10.1016/j.ajog.2004.12.025.Search in Google Scholar PubMed

41. Rosen, C, Brown, J, Heiman, S, Leiblum, C, Meston, R, Shabsigh, D, The female sexual function index (FSFI): a multidimensional Self-report instrument for the assessment of female sexual function. J Sex Marital Ther 2000;26:191–208. 200018. https://doi.org/10.1080/009262300278597.Search in Google Scholar PubMed

42. Elsevier, HW, Putter, H, Delaere, KP, Venema, PL, Lycklama, à, Nijeholt, AA, et al. Female sexual function after surgery for stress urinary incontinence: transobturator suburethral tape vs. tension-free vaginal tape obturator. J Sex Med 2008;5:400–6. https://doi.org/10.1111/j.1743-6109.2007.00671.x.Search in Google Scholar PubMed

43. Chang, SR, Chang, TC, Chen, KH, Lin, HH. Developing and validating a Taiwan version of the female sexual function index for pregnant women. J Sex Med 2009;6:1609–16. https://doi.org/10.1111/j.1743-6109.2009.01247.x.Search in Google Scholar

44. Wilmoth, MC, Hanlon, AL, Ng, LS, Bruner, DW. Factor analysis of the modified sexual adjustment questionnaire-male. J Nurs Meas 2014;22:241–54. https://doi.org/10.1891/1061-3749.22.2.241.Search in Google Scholar

45. Barber, MD, Kuchibhatla, M, Pieper, CF, Bump, RC. Psychometric evaluation of 2 comprehensive condition - specific quality of life instruments for women with pelvic disorders. Am J Obstet Gynecol 6 Nov 2001;185:1388–95. https://doi.org/10.1067/mob.2001.118659.Search in Google Scholar

46. McMillan, SC, Williams, FA. Validity and reliability of the constipation assessment scale. Cancer Nurs 1989;12:183–8. https://doi.org/10.1097/00002820-198906000-00012.Search in Google Scholar

47. Sandvik, H, Seim, A, Vanvik, A, Hunskaar, S. A severity index for epidemiological surveys of female urinary incontinence: comparison with 48-hour pad-weighing tests. Neurourol Urodyn 2000;19:137–45. - Hanley J, Capewell A, Hagen S (2001) https://doi.org/10.1002/(sici)1520-6777(2000)19:2<137::aid-nau4>3.0.co;2-g.10.1002/(SICI)1520-6777(2000)19:2<137::AID-NAU4>3.0.CO;2-GSearch in Google Scholar

48. Hogne Sandvik, H, Espuna, M, Hunskaar, S. Validity study of the severity index, a simple measure of urinary incontinence in women. BMJ 2006 Sep;32218:1096–7. https://doi.org/10.1007/s00192-005-0060-z. Search in Google Scholar

49. Abdel-Fattah, M, Ramsay, I, Barrington, JW. A simple visual analogue scale to assess the quality of life in women with urinary incontinence. Eur J Obstet Gynecol Reprod Biol 2007 Jul;133:86–9. https://doi.org/10.1016/j.ejogrb.2006.04.034Search in Google Scholar

50. Bachmann, G. Urogenital ageing: an old problem newly recognized. Maturitas 1995;(1 Suppl):S1–S5.10.1016/0378-5122(95)00956-6Search in Google Scholar

51. Delgado, DA, Lambert, BS, Boutris, N, McCulloch, PC, Robbins, AB, Moreno, MR, et al. Validation of digital visual analog scale pain scoring with a traditional paper-based visual analog scale in Adults. J Am Acad Orthop Surg Glob Res Rev 2018 Mar;2:e088. https://doi.org/10.5435/jaaosglobal-d-17-00088.Search in Google Scholar

52. Vizintin, Z, Mario Rivera, M, Fistonić, I, Saraçoğlu, F, Guimares, P, Gaviria, J, et al. Novel minimally invasive VSP Er: YAG laser treatments in gynecology. J Laser Health Acad 2012;1:46–58.Search in Google Scholar

53. Fistonic, I, Findri-Gustek, S, Fistonic, N. Minimally invasive laser procedure for early stages of stress urinary incontinence (SUI). J Laser Health Acad 2012;1:67–74.Search in Google Scholar

54. Ogrinc, UB, Senčar, S, Lenasi, H. Novel minimally invasive laser treatment of urinary incontinence in women. Laser Surg Med 2015;47:689–97. https://doi.org/10.1002/lsm.22416.Search in Google Scholar

55. Abdelazim, I. Minimal invasive laser treatment for female stress urinary incontinence. Obstet Gynecol Int J 19 Jul 2015.Search in Google Scholar

56. Gambacciani*, M, Levancini*, M, Cervigni, M. Vaginal erbium laser: the second-generation thermotherapy for the genitourinary syndrome of menopause. Climacteric 2015;18:1–7. https://doi.org/10.3109/13697137.2015.1045485.Search in Google Scholar PubMed PubMed Central

57. Gambacciani, M, Torelli, MG, Martella, L, Bracco, GL, Casagrande, AG, Albertin, E, et al. Rationale and design for the Vaginal Erbium Laser Academy Study (VELAS): an international multicenter observational study on genitourinary syndrome of menopause and stress urinary incontinence. Climacteric 2015;18(1 Suppl):43–8 © 2015 International Menopause Society. https://doi.org/10.3109/13697137.2015.1071608.Search in Google Scholar PubMed

58. Pardo, JI, Sola, VR, Morales, AA. Treatment of female stress urinary incontinence with Erbium-YAG laser in non-ablative mode. Eur J Obstet Gynecol Reprod Biol 2016;204:1–4. https://doi.org/10.1016/j.ejogrb.2016.06.031.Search in Google Scholar PubMed

59. Barber, MA, Eguiluz, I. Patient satisfaction with vaginal erbium laser treatment of stress urinary incontinence, vaginal relaxation syndrome and genito-urinary syndrome of menopause. J Laser Health Acad; 2016. Available from: www.laserandhealth.com.Search in Google Scholar

60. Yi-Wen, T, Sheng-Mou, H, Chien-Nan, L, Ho-Hsiung, L. Effects of laser procedure for female urodynamic stress incontinence on pad weight, urodynamics, and sexual function. Int Urogynecol J 8 Sep 2016. https://doi.org/10.1007/s00192-016-3129-y. [Epub ahead of print].Search in Google Scholar PubMed

61. Gaspar, A, Brandi, H. Non-ablative erbium YAG laser for the treatment of type III stress urinary incontinence (intrinsic sphincter deficiency). Laser Med Sci 2017;32:685–91. https://doi.org/10.1007/s10103-017-2170-5.Search in Google Scholar PubMed

62. Lapii, GA, Yakovleva, AY, Neimark, AI. Structural reorganization of the vaginal mucosa in stress urinary incontinence under conditions of Er: YAG laser treatment. Bull Exp Biol Med 2017;162:510–14. https://doi.org/10.1007/s10517-017-3650-0.Search in Google Scholar PubMed

63. Lin, Y-H, Hsieh, W-C, Huang, L, Liang, C-C. Effect of non-ablative laser treatment on overactive bladder symptoms, urinary incontinence and sexual function in women with urodynamic stress incontinence. Taiwan J Obstet Gynecol 2017;56:815–e820. https://doi.org/10.1016/j.tjog.2017.10.020.Search in Google Scholar PubMed

64. Gaspar, A, Maestri, S, Silva, J, Brandi, H, Luque, D, Koron, N, et al. YAG laser for the management of urinary symptoms of genitourinary syndrome of menopause. Laser Surg Med 2018;50:802–7. https://doi.org/10.1002/lsm.22826.Search in Google Scholar PubMed PubMed Central

65. Blaganjea, M, Š cepanovi _ca, D, Žgura, L, Verdenika, I, Franja, P, Lukanovi _ca, A. * Non-ablative Er: YAG laser therapy effect on stress urinary incontinence related to quality of life and sexual function: a randomized controlled trial. Eur J Obstet Gynecol Reprod Biol 2018;224:153–8. https://doi.org/10.1016/j.ejogrb.2018.03.038.Search in Google Scholar PubMed

66. Fistonić, N, Fistonić, I. Baseline ICIQ-UI score, body mass index, age, average birth weight, and perineometry duration as promising predictors of the short-term efficacy of Er: YAG laser treatment in stress urinary incontinent women: a prospective cohort study. Laser Surg Med 2018;50:1–7.10.1002/lsm.22789Search in Google Scholar PubMed

67. Gambacciani, M, Levancini, M, Russoa, E, Vaccac, L, Simoncinia, T, Cervignic, M. Long-term effects of vaginal erbium laser in the treatment of genitourinary syndrome of menopause. Climacteric 2018;21:148–1. https://doi.org/10.1080/13697137.2018.1436538.Search in Google Scholar PubMed

68. Lin, K-L, Chou, S-H, Long, C-Y. Effect of Er: YAG laser for women with stress urinary incontinence. BioMed Res Int 2019;2019:7915813.10.1155/2019/7915813Search in Google Scholar

69. Lin, H-Y, Tsai, H-W, Kuan-Hao, TY-F, Ching-Chuan, L, Lin, Z-H, Liou, W-S1, et al. The short-term outcome of laser in the management of female pelvic floor disorders: focus on stress urine incontinence and sexual dysfunction. Taiwan J Obstet Gynecol 2018;57:825–e829. https://doi.org/10.1016/j.tjog.2018.10.010.Search in Google Scholar PubMed

70. Okui, N. Comparison between erbium-doped yttrium aluminum garnet laser therapy and sling procedures in the treatment of stress and mixed urinary incontinence. World J Urol 2019;37:885–9. https://doi.org/10.1007/s00345-018-2445-x.Search in Google Scholar PubMed PubMed Central

71. Okui, N. Efficacy and safety of non-ablative vaginal erbium: YAG laser treatment as a novel surgical treatment for overactive bladder syndrome: comparison with anticholinergics and β3-adrenoceptor agonists. World J Urol 2019 Nov;37:2459–66. https://doi.org/10.1007/s00345-019-02644-7.Search in Google Scholar PubMed PubMed Central

72. https://www.ansm.sante.fr/Activites/Publicite-pour-des-dispositifs-medicaux-et-dispositifs-medicaux-de-diagnostic-in-vitro/Recommandations-pour-la-publicite-des-DM-DMDIV/Recommandations-pour-la-publicite-des-DM-DMDIV/Justification-des-allegations-et-comparaisons.Search in Google Scholar

73. Ahluwalia, J, Avram, MM, Ortiz, AE. Lasers and energy-based devices marketed for vaginal rejuvenation: a cross-Sectional analysis of the MAUDE Database. Laser Surg Med 2019 Oct;51:671–7. https://doi.org/10.1002/lsm.23084.Search in Google Scholar PubMed

74. Erel, CT, Inan, D, Mut, A. Predictive factors for the efficacy of Er: YAG Laser treatment of urinary incontinence. Maturitas 2019;132:1–6. https://doi.org/10.1016/j.maturitas.2019.11.003.Search in Google Scholar PubMed

75. Crystle, CD, Charme, LS, Copeland, WE. Q-tip test in stress urinary incontinence. Obstet Gynecol Aug 1971;38:313–5.Search in Google Scholar

76. Kuszka, A, Gamper, M, Walser, CE. YAG laser treatment of female stress urinary incontinence: midterm data. Int Urogynecol J 2020 Sep;31:1859–66. https://doi.org/10.1007/s00192-019-04148-9.Search in Google Scholar PubMed

77. Huang, MH, Chiu, AF, Kuo, HC. Reliability and validity of the King’s Health Questionnaire for male lower urinary tract symptoms in Taiwan. Low Urin Tract Symptoms 2014;6:11–4. https://doi.org/10.1111/luts.12011.Search in Google Scholar PubMed

Received: 2020-02-13
Accepted: 2020-05-06
Published Online: 2020-10-30

© 2020 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Letter to the Editor
  2. Evidence-based medicine is a valuable tool for a successful decision-making on risk-reducing bilateral mastectomy
  3. Original Articles
  4. Melatonin inhibits high glucose-induced ox-LDL/LDL expression and apoptosis in human umbilical endothelial cells
  5. Effects of metformin and insulin therapy regimens on postpartum oral glucose tolerance test results in pregnant women with gestational diabetes mellitus: a comparative study
  6. Association of IL-33 gene rs16924159 polymorphism and recurrent pregnancy loss in Iranian Azeri women
  7. Greater effects of high- compared with moderate-intensity interval training on thyroid hormones in overweight/obese adolescent girls
  8. Effect of Artemisia absinthium ethanolic extract on oxidative stress markers and the TLR4, S100A4, Bax and Bcl-2 genes expression in the kidney of STZ-induced diabetic rats
  9. Associations of endothelial biomarkers, nitric oxide metabolites and endothelin, with blood pressure and coronary lesions depend on cardiovascular risk and sex to mark endothelial dysfunction on the SCORE scale
  10. Association of nitric oxide synthase 3 gene rs1799983 G/T polymorphism with idiopathic asthenozoospermia in Iranian Azeri males: a case-control study
  11. Adiponectin and leptin levels in normal weight women with polycystic ovary syndrome
  12. Review Articles
  13. Association between vitamin D deficiency and prevalence of metabolic syndrome in female population: a systematic review
  14. Vitamin D and sleep duration: Is there a bidirectional relationship?
  15. Challenges of post-traumatic stress disorder (PTSD) in Iraq: biochemical network and methodologies. A brief review
  16. Female urine incontinence: vaginal erbium laser (VEL) effectiveness and safety
  17. Breast cancer risk factors in Iran: a systematic review & meta-analysis
  18. Effects of melatonin supplementation on oxidative stress: a systematic review and meta-analysis of randomized controlled trials
Downloaded on 18.11.2025 from https://www.degruyterbrill.com/document/doi/10.1515/hmbci-2020-0012/html
Scroll to top button