Evidence map›Paper›PMID 42552278›Full record

ArticleInternational urology and nephrology2026

Fractional carbon dioxide vaginal laser for the treatment of urinary symptoms: 36-month results.

Bernadette M M Zwaans, Larry T Sirls, Annah Vollstedt, Natalija Kovacevic, Ly Hoang-Roberts, Esther Han, Lauren Tennyson, Hailey Eisner, Evelyn Shea, Danielle Tenney and 4 more

Abstract read
PubMed Publisher
In one paragraph

Article in International urology and nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. 2024 Canadian Urological Association guideline: Female stress urinary incontinence.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Bernadette M M ZwaansCorewell Health William Beaumont University Hospital, 3535 West 13-Mile Road, Suite 438, Royal Oak, MI, 48073, USA.ORCID http://orcid.org/0000-0002-4717-5751
Larry T SirlsCorewell Health William Beaumont University Hospital, 3535 West 13-Mile Road, Suite 438, Royal Oak, MI, 48073, USA.ORCID http://orcid.org/0000-0003-0412-4994
Annah VollstedtCorewell Health William Beaumont University Hospital, 3535 West 13-Mile Road, Suite 438, Royal Oak, MI, 48073, USA.ORCID http://orcid.org/0000-0002-1819-4275
Natalija KovacevicCorewell Health William Beaumont University Hospital, 3535 West 13-Mile Road, Suite 438, Royal Oak, MI, 48073, USA.ORCID http://orcid.org/0000-0001-5945-7759
Ly Hoang-RobertsCorewell Health William Beaumont University Hospital, 3535 West 13-Mile Road, Suite 438, Royal Oak, MI, 48073, USA.ORCID http://orcid.org/0000-0002-3624-2592
Esther HanCorewell Health William Beaumont University Hospital, 3535 West 13-Mile Road, Suite 438, Royal Oak, MI, 48073, USA.ORCID http://orcid.org/0000-0001-5491-0286
Lauren TennysonCorewell Health William Beaumont University Hospital, 3535 West 13-Mile Road, Suite 438, Royal Oak, MI, 48073, USA.
Hailey EisnerCorewell Health William Beaumont University Hospital, 3535 West 13-Mile Road, Suite 438, Royal Oak, MI, 48073, USA.
Evelyn SheaCorewell Health William Beaumont University Hospital, 3535 West 13-Mile Road, Suite 438, Royal Oak, MI, 48073, USA.
Danielle TenneyCorewell Health William Beaumont University Hospital, 3535 West 13-Mile Road, Suite 438, Royal Oak, MI, 48073, USA.
Jennifer GiordanoCorewell Health William Beaumont University Hospital, 3535 West 13-Mile Road, Suite 438, Royal Oak, MI, 48073, USA.
Jason P GilleranCorewell Health William Beaumont University Hospital, 3535 West 13-Mile Road, Suite 438, Royal Oak, MI, 48073, USA.ORCID http://orcid.org/0000-0002-3233-9696
Priya PadmanabhanCorewell Health William Beaumont University Hospital, 3535 West 13-Mile Road, Suite 438, Royal Oak, MI, 48073, USA.ORCID http://orcid.org/0009-0003-7550-6305
Kenneth M PetersCorewell Health William Beaumont University Hospital, 3535 West 13-Mile Road, Suite 438, Royal Oak, MI, 48073, USA. Kenneth.Peters@corewellhealth.org.ORCID http://orcid.org/0000-0001-9020-598X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeFractional carbon dioxide laser (fCO2) has been proposed to treat vulvo-vaginal symptoms of genitourinary syndrome of menopause (GSM), and urinary symptoms including urgency, urgency urinary incontinence (UUI), and stress urinary incontinence (SUI). The thermal effects of the fCO2 laser can lead to collagen remodeling, improving vaginal tissue integrity and urethral support. Our study aimed to measure the impact of vaginal fCO2 laser therapy on a general group of women with vulvovaginal and urinary symptoms.

methodsWomen with complaints of urogenital symptoms were enrolled in an open-label prospective trial. Participants underwent three laser treatments, each 6 weeks apart. Follow-up consisted of 6-, 12-, 24- and 36-month visits during which cough stress test was performed and questionnaires were administered. ANOVA analysis was used to compare means at each time point.

results100 women, 73 menopausal, with an average age of 55 were enrolled in the study. The PGI-I at 16 weeks showed 32/80 (40.0%) patients were markedly or moderately better, 20/74 (27%) at 6 months, 22/60 (36.7%) at 1 year, 17/44 (38.6%) at 24 months and 17/38 (44.7%) at 36 months. Patients reported significant improvement on the QUID-UUI at all visits out to 36 months, but no significant decrease in UUI episodes was noted. Urinary frequency and OABq symptom and quality-of-life scores significantly improved at each follow-up visit. For those reporting SUI at baseline, SUI leaks were not altered, but  QUID-SUI scores were significantly reduced at each follow-up visit compared to baseline (p < 0.0001). Significant reduction in the incidence of vulvar dryness (p = 0.0016) and vulvar burning (p = 0.0086) were seen.

conclusionOur results show that vaginal fCO2 laser therapy improves vulvovaginal symptoms and urinary symptoms. The urge/OAB patients reported significant durable improvement to 36 months. PGI-I found 44.7% of women markedly or moderately better at 36 months. More research is needed for long-term results.

Indexed as

Genitourinary symptoms of menopauseOveractive bladderUrinary incontinenceVaginal atrophyVaginal laser

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.