NICE: Further Research Needed on Procedure for Urogenital Issues in Women

Priscilla Lynch 

May 28, 2021

The National Institute for Health and Care Excellence (NICE) is calling for more evidence to be gathered on the safety and efficacy of two procedures carried out to treat urogenital conditions affecting women.

The evidence on transvaginal laser therapy for stress urinary incontinence and urogenital atrophy does not show any short-term safety concerns. However, NICE said the evidence on their long-term safety and efficacy is inadequate.

Therefore, NICE’s independent interventional procedures advisory committee has issued guidance that both procedures should only be used in the context of research.

During the procedures, a laser-probe device causes controlled heating of the vaginal wall, which claims to promote tissue remodelling. Treatment typically consists of three sessions at four to six weeks apart. They are used in the private sector, but there does not appear to be evidence recorded of the long-term safety and efficacy of either procedure, NICE said.

For both conditions, NICE already has guidelines that make recommendations for non-surgical treatment.

In NICE's guideline on urinary incontinence and pelvic organ prolapse, first-line treatment is conservative and includes lifestyle changes such as weight loss and pelvic floor muscle training. Surgical options are only offered if conservative measures do not help.

In NICE's guideline on diagnosis and management of menopause, the main treatments for urogenital atrophy are vaginal oestrogen and non-hormonal lubricants and moisturisers.

Prof Kevin Harris, programme director and clinical advisor of NICE’s Interventional Procedures Programme, said: “These two conditions can have a huge impact on the quality of life of the women affected by them."

“If surgical options are required, women deserve safe and effective procedures to treat them."

“The lasers used for these conditions destroy or reshape vaginal tissue. This has the potential for serious risks and there is not adequate evidence that this is safe in the long term."

This article originally appeared on Univadis, part of the Medscape Professional Network.

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