A Retrospective Observational Survey Evaluating Efficacy of diVa Vaginal Laser Therapy for Treatment of Genitourinary Symptoms and Urinary Stress Incontinence

INTRODUCTION: As estrogen levels decrease with menopause, the vaginal epithelium thins and becomes more predominantly parabasal, resulting in more dry and calloused tissue changes (13). This in turn leads to vaginal dryness, dyspareunia, burning, and vaginal spotting as well as urinary symptoms such as frequency, urgency, nocturia, dysuria, and recurrent urinary tract infections (UTIs) (2b). It is hypothesized that laser therapy induces controlled injury to the epidermis of the vaginal mucosa, stimulating tissue repair and remodeling (1). This works independently of estrogen, which could be of great importance in patients with decreased estrogen responsiveness or who are not candidates for estrogen therapy. OBJECTIVE: The aim of this study is to assess the efficacy of the diVa vaginal laser therapy for treating vaginal atrophy, urinary urge, urinary frequency, and stress urinary incontinence and for the prevention of urinary tract infections. METHODS: This is a retrospective survey of patients who underwent the diVa vaginal laser therapy at a tertiary care center between January 2018 and September 2020. Participation was voluntary, and patients were asked to complete a survey with questions regarding genitourinary complaints following their treatment as well as a patient satisfaction improvement inventory. In addition, physical exam findings and the occurrence of urinary tract infections, documented in the electronic medical record as part of standard clinical care, will be collected. Descriptive statistics will be used to characterize participants’ demographic, medical history, and treatment characteristics. The primary study outcome is a change in the clinical survey measures from baseline to follow-up. Each patient’s change from baseline will be calculated, and the Wilcoxon rank-sum test will be used to test whether the change is significantly different from zero. Secondary outcomes will be patients’ self-reported satisfaction and changes in physical exam findings and documented urinary tract infections present in the electronic medical record. RESULTS: 26 patients completed the post-treatment survey and had chart data available. Findings showed that 57.7% of participants felt improvement from baseline in their symptoms, and only 1 person reported their symptoms worsened somewhat. They also showed that 71.4% had improvement in vaginal atrophy on follow-up exam and 57% of patients reported that they were somewhat or very satisfied with their treatment. CONCLUSIONS: This study shows increasing support that vaginal laser therapy may have potential use in the treatment of vaginal atrophy. Future studies should also further assess the potential role of vaginal laser therapy for incontinence and recurrent urinary tract infections.Table 1Table 2