Short-Term Superiority of Transvaginal CO2 Laser versus Radiofrequency in Stress Urinary Incontinence: A 12-Month Retrospective Cohort Analysis

Xiaohua Zheng,1,2 Chaoqin Lin,2 Yunyan Zheng,3 Yu Wang,2 Ying Xu2 1Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350000, People’s Republic of China; 2Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, 350001, People’s Republic of China; 3Department of Obstetrics and Gynecology, 900 Hospital of the Joint Logistic Team Cangshan Branch Hospital, Fuzhou, 350028, People’s Republic of ChinaCorrespondence: Ying Xu, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, People’s Republic of China, 350001, Email 420629627@qq.com Yu Wang, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, People’s Republic of China, 350001, Email wangyu@fjsfy.comBackground: Approximately 20% of females experience stress urinary incontinence (SUI) during their lifetime. Emerging energy-based therapies, such as CO2 laser and radiofrequency (RF), lack comparative evidence regarding efficacy stratification based on disease severity and patient characteristics.Objective: This study aims to compare the 6- and 12-month outcomes of transvaginal dot-matrix CO2 laser therapy versus AI temperature-controlled RF therapy in SUI patients, categorized by symptom severity.Methods: A retrospective analysis was conducted on 106 women (52 treated with laser therapy and 54 with RF therapy) who received standardized treatments. Primary outcomes included the reduction in the 1-hour urine pad test and changes in Questionnaire of International Consultation on Incontinence Questionnaire-Short Form (ICI-Q-SF) scores, while secondary outcomes comprised Patient Global Impression of Improvement (PGI-I) scores and complication rates.Results: After 6 months, the laser group exhibited a higher overall effective rate compared to the RF group (86.5% vs. 70.4%), with particularly superior outcomes in patients with mild SUI (pad test: 92.6% vs. 58.8%, p=0.017; ICI-Q-SF: 5.35 ± 3.11 vs. 6.98 ± 3.86, p< 0.05). After 12 months, therapeutic equivalence was observed across all SUI severities, although RF demonstrated better sustained efficacy in moderate to severe cases (pad test: 70.27% vs. 40%, p=0.018; PGI-I: 2.87± 0.89 vs. 3.37± 1.01, p=0.009).Conclusion: CO2 laser therapy provides rapid symptom control for mild SUI, whereas RF therapy offers greater durability in more severe cases. These findings suggest that treatment modality selection should be personalized based on the severity of the disease and duration.Keywords: stress urinary incontinence, transvaginal, CO2 laser, radiofrequency, laser