Discrete Mathematics in Dynamic Network Analysis: Long-Term Efficacy Evaluation of Fotona Laser Therapy for Overactive Bladder Syndrome Using Clustering-Based Patient Subgroup Identification

Dynamic network analysis, a state-of-the-art application of discrete mathematics, offers unprecedented insight into complex, time-evolving clinical data. This technical report demonstrates the value of evaluating the long-term efficacy of Fotona laser therapy (Fotona d.o.o., Ljubljana, Slovenia) in overactive bladder (OAB) syndrome. We analyzed data from 101 female patients aged ≥60 years who underwent Fotona laser treatment, including Vaginal Erbium Laser (VEL) and Urethral Erbium Laser (UEL), between 2020 and 2022. OAB symptom scores (OABSS) were collected at baseline (T0) and at six, 12, 18, and 24 months post treatment. Network graphs were constructed, representing patients as nodes, and symptom similarities as edges. Clustering techniques identify patient subgroups, whereas principal component analysis reduces dimensionality. The dynamic evolution of patient clusters was visualized through changes in average degree centrality over time. This approach revealed three distinct patient clusters with unique treatment response patterns. The results showed a progressive reduction in OABSS, with the total score decreasing by 2.82 ± 3.03 at 24 months. Our method provides novel visualization and analysis of complex longitudinal clinical data, offering insights into personalized treatment strategies for OAB. This report presents one of the first applications of discrete mathematics and dynamic network analysis to evaluate the long-term outcomes of Fotona laser therapy for OAB and introduces an innovative perspective for clinical decision-making in urogynecology.