Stres üriner inkontinans tedavisinde Er:yag lazer uygulanan hastalarda transperineal ultrason bulgularındaki değişiklikler

Aim: Stress urinary incontinence (SUI) is defined as the involuntary leakage of urine during coughing, sneezing, physical exertion, or exercise. Its prevalence varies with age (29%-75%), with an average of 48% (1-2). Laser is one of the non-invasive methods used in treatment (3). This study aimed to evaluate transperineal ultrasound findings before and after laser treatment in patients treated for stress urinary incontinence.Materials and Methods: The study included 13 patients with stress urinary incontinence who underwent Er:YAG laser treatment at the Urogynecology Clinic of Istanbul University Faculty of Medicine Hospital. The mean age of the patients was 47.69 years (range: 36–63), and the mean BMI was 29.13 (range: 21.7–39.3). Patients received three sessions of urethral and vaginal Er:YAG laser treatments at one-month intervals. Bladder wall thickness, urethral length, urethral wall thickness, and genital hiatus width were evaluated with transperineal ultrasound before the treatment and at the third month following the completion of the treatment.Results: After treatment, a reduction in bladder wall thickness was observed, but the difference was not statistically significant (p=0.245). A significant increase in urethral length (p=0.002), an increase in urethral wall thickness (p=0.008), and a reduction in genital hiatus width (p<0.001) were observed, and these findings were statistically significant.Conclusion: Significant changes related to the etiology of stress urinary incontinence were observed in transperineal ultrasound findings before and after Er:YAG laser treatment. While bladder wall thickness, which is associated with urge urinary incontinence, did not show a significant change with laser treatment, the increases in urethral length and urethral wall thickness, mechanisms preventing stress urinary incontinence, showed significant improvement. The reduction in genital hiatus width indicates that laser treatment strengthens pelvic floor muscles and helps prevent incontinence.