I am one of the first practitioners in Canada to introduce and offer direct, intra-urethral but office based laser treatment for certain types of difficult to treat urethral buring and irritation, stress urinary incontinence and overactive bladder symptoms. Currently certain types of chronic urethral burning, and overactive bladder symptoms are very difficult to treat, and in some cases almost untreatable because of associated medical problems that rule out surgery. Our current treatment options for some such situations are highly unsatisfactory, and often don’t work very well. The same is often true for overactive bladder (OAB), if this is related to leaking of urine into the urethra, or to atrophy of the urethra. Intra-urethral laser also contributes to the efficacy of vaginal laser for some cases of stress urinary incontinence, especially where there is a problem with the internal pressure in the urethra (in medical circles this is considered 'intrinsic sphincter deficiency', or more commonly; 'low pressure urethra'.
I have treated a number of patients who have suffered for years with symptoms of urethral burning or irritation, and where simply nothing works. Many of these patients keep getting treated for urinary tract infections, often in desperation even in the absence of positive lab cultures, simply because both the patient, as well as her doctor, are out of other ideas. In a number of cases the laser resulted in immediate albeit usually temporary relief. The good news is that the interval of required laser treatments are usually between six and twelve months. Considering that the treatment takes less than ten minutes and is completely painless, it is a definite option to consider.
This new treatment involves a two to three millimeter probe that is gently introduced into the urethra, through which the laser energy will be applied. The whole process takes a few minutes and having done numerous procedures during my training with the Laser and Health Academy, as well as now in Calgary, I can confirm that it is extremely well tolerated. The improved thickness and health of the tissue inside the urethra in case of the intra-urethral laser improves the 'coaptation' of the urethra. This is the 'closing ability' of the inside walls of the urethra, which plays a major role in preventing leaking, and urine escaping, as well as urine leaking into the urethra, setting off symptoms of urgency and frequency (having to go frequently and called 'overactive bladder', or OAB). The reason the laser helps for 'burning urethra' syndrome, is because of improvement in the 'barrier' effect of the internal urethral mucosa to urine contents that causes burning if able to cross the barrier and reach deeper lying nerve endings. The laser literally causes a 'barrier' to these noxious substances reaching the nerves; thus no more burning urethra!
This new treatment modality will usually be combined with the intra-vaginal laser I currently do for incontinence and/or vaginal dryness or thinning, usually because of menopause. It is not a stand-alone procedure in most cases, (unless urethral burning is the ONLY issue of concern) but an additional procedure to try and improve the expected treatment results and outcomes in certain cases. Not everyone will require this addition however.
Here is an animation of the procedure: