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Quality and Reliability of Publicly Accessible Information on Laser Treatments for Urinary Incontinence: What is Available to our Patients?

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D. Perruzza1, A. Butti1, C. Jolliffe2, C. McCaffrey2, R.C. Kung2, L.H. Gagnon2, P.E. Lee2

1.Faculty of Medicine, University of Toronto, Toronto, ON;     2.Division of Urogynecology, Department of Obstetrics and Gynecology, SHSC, Toronto, ON


Stress Urinary Incontinence

  Involuntary urinary leakage associated with activity, stress urinary incontinence (SUI), affects up to 1/3 of adult women.1-3 There are different treatments available ranging from physiotherapy (pelvic floor exercises), wearing vaginal devices, and surgery. 2,4 This condition can be very troubling and affect quality of life through impacting physical, social, economic and psychological aspects of a woman’s life. 5-7 LASER vaginal treatment is a new and innovative way to treat SUI and can be performed in an office setting: offering women the choice of a minor procedure without the risks associated with regular surgery. 8-11 The procedure involves the application of LASER generated heat to vaginal tissues which triggers the restructuring of vaginal collagen resulting in a ‘lift’ to the anterior wall of the vagina – thereby having the effect of improving mild SUI. 9 There are very few reported risks and complications compared to surgery. Although the LASER has been approved by the FDA and Health Canada, its utility in UI is not clear.

What do patient’s know?

  Due to the novel nature of these treatments, there is limited information available to the public. Moreover, there has yet to be an analysis done on the quality and understandability of the information that is currently available.


The aim of this study is to determine the quality and reliability of the top 20 internet search results on laser treatment of urinary incontinence.


Website Selection

•The phrases “laser treatment of urinary incontinence” and “vaginal laser therapy for urinary incontinence” were searched in the most popular search engines (Google)
•Data suggests that 95% of people will not look past the first page (10 results) of a google search. 12
•To ensure the majority of sites visited by patients were assessed, the top 20 were chosen for analysis
•The results (as of August 2018) were analyzed by 2 medical students, 2 gynecology fellows and 3 urogynecologists and inter-rater reliability was assessed.

 Website Analysis

Ease of Readability was determined using standard automated measures with the Flesch-Kincaid grade level (FKGL) and automated readability index (ARI). 13
The quality, credibility and transparency of information was determined using standardized tools judged by the reviewers:
•DISCERN instrument: 16 domains measuring reliability, quality and overall score 14
•HON (Health on the Net) foundation certification: ensures website developers maintain basic ethical standards in information presentation and provide readers with a source and purpose of the data provided. 15
•JAMA Benchmarks: domains of correct attribution, disclosure, currency of the information and disclosure of authorship.16
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