A Comparison between Anteroposterior Colporrhaphy and Erbium YAG Laser Interventions in the Treatment of Postpartum Stress Urinary Incontinence: Promising Win for the Erbium YAG laser
Abstract
Taghreed Salah Alquzwini
Background: Stress urinary incontinence (SUI) is a well-known health issue that affects the lifestyle quality of women after childbirth with a high prevalence rate. Pregnancy is considered the principal risk initiator of SUI.
Objectives: The present comparative clinical study was conducted to evaluate the effectiveness of both anteroposterior colporrhaphy (APCP) and Erbium YAG laser (EYL) interventions in the treatment of SUI after childbirths.
Patients and interventions: For the current investigation, 95 female patients who had visited the private obstetrics and gynecology clinic of the current researcher were randomly assigned as 45 moderate-case patients for the APCP that needed only a one-time procedure and 50 mild-to-moderate-case patients for the EYL, which required 3-7 sessions/two weeks apart. Follow-up visits of these patients were performed to monitor their health status and results for up to six months. Results: The EYL intervention showed overall favorite outcomes over these from APCP. EYL revealed significant (p˂0.01) of no complications such as post-procedure pain (PPP) and post-procedure vaginal bleeding (PPVB), but 45 (100%) and 6 (13.3%) patients from APCP had these symptoms, respectively. Besides, patients who had the EYL treatment significantly (p˂0.01) did not need bed rest and sexual withdrawal after the procedure at all; however, all cases from the APCP intervention needed bed rest and sexual withdrawal as part of the post-operative care. Significantly (p˂0.01), none of the EYL patients had dyspareunia symptoms while they appeared in 4 (8.9%) of the APCP patients. Relief of symptoms was seen in a comparable outcome with a significant (p˂0.01) slight difference in favor of the APCP over the EYL intervention, 43 (95.6%), and 41 (82%), respectively. Moreover, recurrence of the SUI over the six-month follow-up surveillance was noticed to be in close results with a significant (p˂0.01) small margin in favor of the APCP over the EYL procedure, 2 (4.4%) and 3 (6%), respectively.
Conclusion: The Erbium YAG laser could be the best choice for treating SUI to avoid the profound post-operative care and appearance of the complications when using the anteroposterior colporrhaphy.