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Correspondence to Author: Mariana Quiroga, MD, PhD¹; Pablo Esteban Cortéz, MD²; Isabela Monteiro, MD³. 

¹Department of Gynecology, Universidad Médica de Buenos Aires, Buenos Aires, Argentina. ²Department of Gynecology, Hospital Universitario de Santiago, Santiago, Chile. ³Department of Reproductive Medicine, Universidade Federal de São Paulo, São Paulo, Brazil

DOI: 10.52338/jocogr.2026.5814

Abstract:

Background: Stress urinary incontinence, mixed urinary symptoms, genitourinary syndrome of menopause, vaginal atrophy, cervical ectopy/ erosion, and early uterine prolapse are common gynecologic conditions associated with impaired quality of life, reduced sexual function, recurrent discomfort, and high long-term healthcare utilization. Energy-based vaginal therapies have been investigated as minimally invasive approaches for collagen remodeling, epithelial restoration, angiogenesis, and pelvic floor tissue support. However, clinical adoption requires careful evaluation of safety, standardized treatment parameters, validated outcome instruments, and biologically plausible evidence of tissue response.
Objective: This multicenter clinical study evaluated the safety and preliminary effectiveness of the Heager GmbH Sabrina/Adolf TRIAC laser system, a dual-wavelength platform incorporating independent 1470 nm and 980 nm laser generators, erbium-doped glass fiber transmission, a three-directional vaginal probe, and an integrated multiplex wavelength processor for controlled single-wavelength or hybrid wavelength delivery in selected urogynecologic and vaginal regenerative indications.
Methods: A prospective multicenter cohort study was conducted in women aged 35–65 years with stress urinary incontinence, urinary incontinence symptoms, vaginal atrophy/genitourinary syndrome of menopause, cervical ectopy/erosion, or first-degree uterine prolapse. Participants underwent three outpatient laser treatment sessions at baseline, week 4, and week 8. Clinical outcomes included International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), Vaginal Health Index (VHI), one-hour pad test, patient global improvement, and adverse event monitoring. Imaging and biological substudies included transvaginal or translabial ultrasonography, histopathologic assessment using Masson’s trichrome staining, epithelial thickness assessment, vascular markers including CD31, proliferative markers including Ki-67, and molecular markers associated with photothermal tissue response and remodeling, including heat shock protein 70 (HSP70), vascular endothelial growth factor (VEGF), and transforming growth factor beta (TGF-β). Follow-up was performed through 6 months.
Results: Among 100 treated participants, mean ICIQ-SF scores improved from 14.2 at baseline to 5.2 at 6 months, corresponding to a 63.4% relative reduction in symptom burden. The Vaginal Health Index improved from 11.4 to 20.1. Eighty-seven percent of participants with baseline stress urinary leakage demonstrated a negative or substantially improved one-hour pad test at follow-up. Sonographic analysis demonstrated increased vaginal mucosal thickness, with a mean increase of approximately 1.4 mm. Histopathological and immunohistochemical assessment demonstrated increased collagen organization, epithelial restoration, increased vascular density, and enhanced proliferative activity. Molecular assessment demonstrated increased expression of HSP70, VEGF, and TGF-β after treatment. No serious device-related adverse events were reported. Mild transient warmth or discomfort occurred in 12% of participants and resolved without intervention..
Conclusion: In this multicenter cohort, TRIAC laser therapy using the Heager GmbH Sabrina/Adolf dual-wavelength system was associated with clinically meaningful improvements in urinary symptoms, vaginal tissue health, mucosal thickness, collagen remodeling, and molecular markers of tissue repair, with no serious adverse events observed during short-term follow-up. These findings support further evaluation in randomized, sham-controlled trials with longer follow-up, standardized dosimetry, and independent histologic validation.

Citation:

Dr. Smith Clinton MD, Dual-Wavelength Triac Laser Therapy Using The Heager Gmbh Sabrina/Adolf System For Stress Urinary Incontinence, Genitourinary Syndrome Of Menopause, Cervical Ectopy/Erosion, And FirstDegree Uterine Prolapse: A Multicenter Clinical, Sonographic, Histopathological, And Molecular Study. Journal of Clinical Obstetrics and Gynecology Research 2026.