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Klap J, Campagne-Loiseau S, Berrogain N, Bosset PO, Cardot V, Charles T, Deffieux X, Donon L, Girard F, Peyrat L, Roulette P, Thuillier C, Tibi B, Vidart A, Wagner L, Hermieu JF, Cornu JN. [Vaginal LASER therapy for genito-urinary disorders: A systematic review and statement from the Committee for Female Urology and Pelviperineology of the French Association of Urology]. Prog Urol 2021; 31:634-650. [PMID: 33516611 DOI: 10.1016/j.purol.2020.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 11/08/2020] [Accepted: 11/09/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Vaginal LASER therapy is increasingly used in the field of urogynecology, but several points remain unclear. Our goal was to produce a systematic review of available evidence and provide a critical appraisal of available data. METHODS A systematic review until march 2020 was conducted using PubMed/MEDLINE, Cochrane and Embase databases. All studies about vaginal LASER use in the field of urogynecology were included. RESULTS Forty studies have been included (8 for genitourinary syndrome of menopause, 19 for stress urinary incontinence, 3 for overactive bladder, 7 for urogenital prolapse, 3 for other indications). Data were heterogeneous, and level of evidence was weak or very weak. Few studies were comparative, and only 3 were randomized). Mild improvement of symptoms and quality of life and limited satisfaction were seen for genitourinary syndrome, stress urinary incontinence, overactive bladder and prolapse. Few adverse events were reported. However, major methodological biases were noted regarding efficacy and safety evaluation. No long-term results were available. CONCLUSIONS While Vaginal LASER therapy seem to provide encouraging results, the level of evidence supporting its use was weak, especially regarding long-term outcomes. Studies of better quality are warranted before any recommendation can be made. Current use should be limited to clinical research.
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Affiliation(s)
- J Klap
- Service d'urologie, hôpital privé Claude-Galien, 91480 Quincy-sous-Senart, France
| | - S Campagne-Loiseau
- Service de gynécologie-obstétrique, CHU d'Estaing, Clermont-Ferrand, France
| | - N Berrogain
- Clinique Ambroise-Paré, 31100 Toulouse, France
| | - P O Bosset
- Service d'urologie, hôpital Foch, 40, rue Worth, 92150 Suresnes, France
| | - V Cardot
- Clinique de Meudon-Clamart, 3, avenue de Villacoublay, 92360 Meudon, France
| | - T Charles
- Service d'urologie, CHU de La-Miletrie, 86000 Poitiers, France
| | - X Deffieux
- Service de gynécologie-obstétrique, hôpital Antoine-Béclère, AP-HP, 92140 Clamart, France
| | - L Donon
- Clinique de la Côte Basque, 64100 Bayonne, France
| | - F Girard
- Service d'urologie, clinique Oudinot fondation Cognac-Jay, 2, rue Rousselet, 75007 Paris, France
| | - L Peyrat
- Service d'urologie, clinique Turin, 75008 Paris, France
| | - P Roulette
- Service d'urologie, centre hospitalier de Cahors, 335, rue Wilson, 46005 Cahors cedex, France
| | - C Thuillier
- Service d'urologie, CHU de Grenoble-Alpes, 38000 Grenoble, France
| | - B Tibi
- Service d'urologie, hôpital Pasteur 2, CHU de Nice, 30, voie Romaine - CS 51069, 06001 Nice cedex 1, France
| | - A Vidart
- Service d'urologie, hôpital Foch, 40, rue Worth, 92150 Suresnes, France
| | - L Wagner
- Service d'urologie, CHU de Nîmes, place du Pr-Robert-Debré, 30029 Nîmes cedex 9, France
| | - J-F Hermieu
- Service d'urologie, hôpital Bichat, AP-HP, Paris, France
| | - J-N Cornu
- Service d'urologie, hôpital Charles-Nicolle, université de Rouen, 76000 Rouen, France.
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