Efficacy and safety of postoperative vaginal laser therapy in women with an implanted TVT-O sling for the treatment of stress urinary incontinence

Modern surgical treatment of stress urinary incontinence in women is sling surgery, the effectiveness of which ranges from 52% to 90%. The search for opportunities to improve the results of such surgical interventions remains a relevant direction in modern gynecology. Aim - to study the effectiveness and safety in surgical treatment of using the transobturator location of the prolene loop TVT-Obturator (Tension Free Vaginal Tape - Obturator - TVT-О) combined with vaginal laser therapy in the postoperative period. Materials and methods. The data of urination diaries and evaluations according to the ICIQ-SF questionnaire were compared in two representative groups of patients: in the I group, 28 women with stress urinary incontinence underwent plastic free synthetic loop (TVT), in the II group (n=30) - TVT-O was performed and vaginal laser therapy in the postoperative period. Statistical data processing was carried out using the SPSS 21 program. Results. 2 years after surgery, objective cure and subjective improvement were found in 96.7% and 100% of women in the TVT-O group who received laser therapy in the postoperative period, which is significantly higher than 78.6% and 82.1% in the TVT group. A significant decrease in the average number of urinary incontinence episodes according to urination diaries and the average weight of pads was found. When evaluating the subjective indicators, no statistically significant differences between the groups were found, however, according to the ICIQ-SF questionnaire, the frequency of improvement in the quality of life was significantly more frequent in the group of TVT-O and vaginal laser therapy. Conclusions. When evaluating the results of treatment 2 years after the intervention, the effectiveness of TVT-O surgery, combined with postoperative vaginal laser therapy according to objective criteria, is statistically significantly higher than the effectiveness of TVT surgery. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors.