A new approach to treatment of stress urinary incontinence using non-ablative transurethral laser

非剥脱性经尿道激光治疗压力性尿失禁的新方法

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作者:Hwarang Shin, Yeachan Lee, Seonghee Lim, Minh Duc Ta, Van Gia Truong, Myungji Kang, Hyun Wook Kang

Abstract

Stress urinary incontinence (SUI) is a prominent incontinence caused by increased abdominal pressure. Sling treatments are surgical procedures used to treat SUI by inserting an artificial mesh into the urethra. However, after the sling treatments, patients can be at risk of chronic pain and infection in the urological system. The current research aims to develop new non-ablative transurethral laser treatment for SUI as a minimally invasive and non-implantable procedure. Six females porcine were randomly divided into three groups: Control, day 0 and day 28 after laser treatment. The urethra was dilated using a balloon-assisted diffusing applicator and irradiated with a 980-nm laser light at 20 W for 15 s. To compare the efficacy of the treatment, urethral tissues were harvested on days 0 and 28 for histological evaluation. 28 days after the laser treatment, the urethra thickness was 46% greater than the control group, indicating an increase in collagen deposition in the urethra. The transurethral laser treatment groups exhibited significantly higher levels of collagen reconstruction-related proteins (VEGF and collagen type 3), compared to the control group, without causing thermal damage to the urethral mucosa. The current findings demonstrated the feasibility of the non-ablative transurethral laser treatment for SUI without thermal damage to the urethral mucosa. Further investigations will be pursued to validate functional and molecular changes of the laser-treated urethra in a disease-induced animal model in order to warrant the efficacy and safety of the transurethral laser treatment for clinical translations.

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