Urinary incontinence is a chronic health problem commonly found in women worldwide. Urinary incontinence symptoms can be divided into 3 groups: The first group is often found in people with neurological and brain disorders, characterized by continuous urine leakage (Overflow), requiring the use of sanitary pads. Even normal walking or walking a bit faster causes urine leakage. The second group experiences urine leakage during exertion, especially during activities such as coughing, sneezing, playing sports, or lifting heavy objects. This group accounts for about half of all patients. The third group is called overactive bladder, where urine leakage occurs before reaching the bathroom when the urge to urinate begins, along with frequent urination.
The cause of stress urinary incontinence comes from prolonged increased pressure in the abdominal cavity, resulting in weakened muscles in the vaginal wall. The bladder and urinary tract change their angle. When exerting effort such as lifting heavy objects or playing sports, which increases abdominal pressure, urine leaks out. Vaginal wall weakness can occur from various causes such as being overweight, chronic constipation, causing constant abdominal pressure. It is also commonly found in people who exercise heavily and lift heavy objects for a long time, or even pregnancy and childbirth, especially difficult deliveries, which can cause vaginal tissue to weaken and be injured, known as pelvic floor relaxation, potentially leading to stress urinary incontinence, especially in women who do not perform proper postpartum exercises.
If symptoms are still in the early stage, doctors usually recommend patients to perform vaginal muscle exercises (Kegel exercises). If done correctly and consistently, at least 30 times per session, three times a day (morning, noon, and evening), it can help prevent pelvic floor relaxation and urinary incontinence. However, in some cases where patients cannot focus on vaginal exercises throughout the day, devices are needed to assist. Phyathai 2 Hospital offers a popular technology called Fractional CO2 laser vaginal tightening (Monalisa Touch). This technology comes with a scanner specifically designed for the female vagina, capable of emitting laser light 360 degrees to stimulate fibroblast cells, helping to produce and arrange collagen fibers better. Besides treating urinary incontinence, it also helps tighten the vagina, relieve vaginal dryness and inflammation, and improve the external area’s smoothness and brightness.
Laser treatment works by destroying old cells and increasing collagen production in vaginal tissue. Normally, tissue elasticity is due to collagen in the dermis layer, but as age increases and menopause approaches, tissue degenerates with age or due to other factors such as obesity, pregnancy, and difficult childbirth, causing collagen reduction. Laser treatment destroys the surface cells and stimulates new collagen formation.
Those who want laser treatment for urinary incontinence must undergo a physical examination to assess the severity of the condition first. Laser tightening technology is suitable for mild urinary incontinence, such as leakage only during heavy sports, certain intense fitness classes, or when patients feel vaginal looseness or air leakage from the vagina. If the condition worsens, surgery may be necessary. Surgical treatment for urinary incontinence, whether open abdominal surgery to lift the bladder angle or using sling tape to lift the bladder angle, helps restore the normal angle of the urethra but does not tighten the vagina. Unlike laser treatment, which can address both symptoms simultaneously. Also, some women who are unhappy with their sexual life, even without urinary incontinence, can undergo laser treatment to tighten the vagina.
Mild urinary incontinence treatment or vaginal tightening with laser requires three sessions, with one visit per month. Each session takes about 10-15 minutes, does not require hospitalization, anesthesia, or cause pain. After treatment, patients can return home and resume normal activities. It is also less expensive than surgery and has very few side effects, almost none, except for increased vaginal discharge during the first week. Therefore, it is considered an interesting new treatment option.
Dr. Thanomsiri Satit
Gynecologic Oncology Specialist
Women’s Health Center, Phyathai 2 Hospital
Gynecologic Oncology Specialist
Women’s Health Center, Phyathai 2 Hospital
