If there’s a laser technique for a medical ailment then everyone wants it. Lasers sound modern, non-invasive and just “cool.” However, just because a laser is available, doesn’t mean it’s always the best therapy.
Laser treatment for female incontinence is quickly gaining in popularity. With a variety of products on the market, it’s important to do your research and gather accurate data. Luckily for you, we’ve done the research for you.
Let’s review the latest information on laser treatment for female incontinence so you see if it’s right for you.
What is laser therapy for female incontinence?
Laser stands for light amplitude by stimulated emission of radiation (uh what?). Fancy doctor term for changing light or electrical energy into a focused beam of energy. A “laser beam”.
Laser therapy for female incontinence is typically delivered in an office setting while you are awake. During the therapy sessions, the laser is directed to the vaginal lining to cause changes to the pelvic tissues supporting the urethra and bladder.
Why does laser therapy help female incontinence?
The two most common types of urinary incontinence are stress incontinence and urge incontinence.
Stress incontinence is the involuntary loss of urine with coughing, laughing and lifting. When you bounce on a trampoline with your granddaughter or daughter, this is stress incontinence. It is most often caused by urethral hypermobility; a fancy doctor term for the urethra is no longer well supported due to child birth and/or aging.
The main support system to the urethra is collagen. Collagen is the primary protein supporting our tissues. Collagen levels have been found to be lower in women with stress urinary incontinence. Low female hormone levels post-menopause play a role as well.
Laser therapy for female incontinence increases collagen levels in the pelvic tissues supporting the urethra. In other words, there’s actual science to support the use of laser therapy for female incontinence.
The laser energy and heat stimulates the lining of the vagina to contract the existing collagen (tighten it). Laser therapy for female incontinence also stimulates the production of new collagen, blood vessels, and helps to thicken the lining of the vagina.
These internal changes lead to side benefits of laser therapy for female incontinence. In fact, most women perform laser therapy for these “vaginal rejuvenation” benefits, not for urinary incontinence:
- Improved vaginal moisture
- Less pain during intercourse (dyspareunia)
- Vaginal tightening
- More enjoyable sex.
Laser therapy may also help urge incontinence. This is a leakage of urine before you can get to the bathroom in time. Sometimes you’ll get a “warning” (urinary urgency) and sometimes you won’t. Urge incontinence is most often due to an overactive bladder (OAB).
How can laser therapy help urge incontinence?
First, some urge incontinence is brought on by stress incontinence. When a small amount of urine is leaked into the urethra with a cough, the bladder then responds with full contraction. This is called stress-induced urge incontinence. If laser therapy fixes the stress incontinence, then the urge incontinence may disappear.
Next, laser therapies that penetrate the deeper tissues of the vagina can stimulate collagen growth in the pelvic floor. This increased support may help calm an overactive bladder.
What are the different types of laser therapy for female incontinence?
The vagina has three layers of tissue (inner lining, muscle, outer connective tissue). The type of laser therapy used for female incontinence determines the depth of penetration into these various layers. In turn, this determines what effects (good or bad) laser therapy for female incontinence may cause.
These laser therapies for female incontinence are delivered in the office setting using a vaginal probe.
Er:YAG laser therapy for female incontinence
Er:YAG or erbium-doped yttrium aluminium garnet (that’s a mouthful) refers to the crystal used in the laser device. It is strongly absorbed by water and has numerous applications in dentistry and cosmetics.
The primary Er:YAG laser therapy for female incontinence is the:
- Fotona SMOOTH® IncontiLase®.
When Er:YAG laser therapy is used for female incontinence, it causes a controlled heating of the collagen in the deeper vaginal layers without harming the delicate inner lining or mucosa. This causes new collagen formation and tightening of the surrounding pelvic tissues.
Laser therapy sessions are delivered in the office in about 20 minutes. Usually no anesthesia is required and most women report little to no pain. Other women report more of a “warm” sensation during the treatments and local anesthesia creams can be used.
Expect a quick recovery with this non-invasive, non-ablative laser therapy for female incontinence. Anywhere from 2 to 3 sessions are typically delivered.
CO2 laser therapy for female incontinence
Instead of a crystal, this laser uses the gas carbon dioxide (CO2). Compared to the Er:YAG laser, the CO2 laser therapy leads to:
- Deeper tissue penetration
- Ablation (scarring of tissue)
- Larger area of treatment effect
What does this mean for women? CO2 laser therapy for female incontinence may cause more discomfort for up to 48 hours after the therapy session but in return, it may lead to longer lasting effects.
There are two main CO2 laser therapies on the market:
- MonaLisa Touch®
Radiofrequency ablation: non-laser therapy for female incontinence
Technically speaking, radiofrequency ablation (RFA) is NOT a laser therapy for female incontinence. RFA uses medium frequency alternating currents to deliver energy that ablates or destroys tissues.
Since it is used to treat many of the above conditions, and it still involves a wand being put “you know where”, we wanted to include RFA in our laser discussion.
Similar to CO2 laser therapy for female incontinence, there are multiple vaginal RFA devices on the market:
- Viveve (also makes non-energy biofeedback devices for urinary incontinence)
- Ultra Femme 360TM
Due to a different delivery of energy, RFA providers claim a shorter downtime with no recovery compared to CO2 laser therapies. The “wand” in some cases is smaller than laser wands. RFA also delivers energy deeper to the vaginal tissues.
Does laser therapy for urinary incontinence work?
This is the million dollar question. To date, the only published data supporting the use of laser therapy for urinary incontinence is with the Er:YAG laser. All other reports are anecdotal or made by providers who make money off the devices.
An unbiased review article cites multiple studies showing the efficacy of the Er:YAG laser in treating urinary incontinence.
Since most laser therapies are primarily performed for “vaginal rejuvenation”, improvement in urinary incontinence is often a secondary benefit that has not been formally studied.
Radiofrequency ablation specifically for urinary incontinence has been evaluated in a pilot study. However, this device was delivered only through the urethral opening and would not be used for “vaginal rejuvenation.”
What is the best laser therapy for urinary incontinence? How do I choose?
Researching these different devices is anxiety provoking even for us as board-certified specialists! Sorting through “sales claims” versus scientific evidence can be challenging.
For the record there are no head-to-head trials of these different laser therapies for urinary incontinence. Most online information comes directly from the companies that produce the laser therapy or practices that own the systems.
In other words, if a practice has the MonaLisa then they claim on their website that MonaLisa is the best therapy, if they use ThemiVA then apparently that’s “the best.” You get the idea.
But fear not, we have some guidelines for you:
- Laser therapy for urinary incontinence needs to be further studied
There just isn’t enough data to fully support laser therapy for urinary incontinence alone. Hopefully in the future, we will have a better answer. There’s no doubt that laser therapies help various vaginal symptoms (dryness, pain with intercourse etc.). Just be sure to temper your expectations for improvements with bladder control.
- The Er:YAG laser therapy best treats urinary incontinence
If you’ve decided on laser therapy for vaginal rejuvenation AND you have urinary leakage, then the Er:YAG laser therapy has the best published data for treating urinary incontinence. If you choose a different laser therapy for urinary incontinence (CO2 or RFA), then understand any promise of treating bladder leakage is not currently backed by science.
- Meet with a female urology specialist who can discuss all urinary incontinence therapies.
Before you spend your hard-earned money on a laser therapy for urinary incontinence, have a consultation with an unbiased expert. There are a number of non-laser treatments for urinary incontinence and vaginal rejuvenation.
- Vaginal estrogen cream
- Hormone replacement therapy
- Dietary and lifestyle changes
- Pelvic floor physical therapy
- Mid-urethral sling for stress incontinence
- Sacral neuromodulation or Botox injection for urge incontinence
You should pick the one that’s best for you.
Here at VirtuCare we’re not financially incentivized to sell you on a particular therapy. These laser therapy machines can cost a medical practice over $100,000 to purchase! That’s a big investment to try and recoup.
That’s not to say that there aren’t wonderful specialists with good intentions. Instead just remember that medical therapies are a big business.
At VirtuCare we believe in getting you the care you deserve from the comfort of your home. As urology telemedicine specialists, we have no incentive to recommend a therapy that we don’t perform (although it would be pretty cool to remotely control a laser).
A telemedicine visit with a few simple clicks will give you access to our team of specialists in no time. If you decide that you need laser therapy for urinary incontinence, then let us find you the best doctor for the job.
You don’t want anyone but the best putting a laser wand in your lady business!