Abstract

Objectives: 1. Acquire a thorough understanding of the sophisticated working mechanism and defining technical specifications—specifically the pixelated emission mode and micron-level depth control—that underpin the multifocal CO₂ laser system. 2. Critically evaluate the robust clinical efficacy and safety data of this laser therapy, as demonstrated through large-scale, real-world clinical experience involving over ten thousand cases in China. Introduction: Stress urinary incontinence (SUI) is a prevalent condition affecting 18.9% of adult Chinese women, significantly impairing quality of life. Traditional treatments range from pelvic floor exercises to midurethral sling surgery. In recent years, minimally invasive laser therapy has emerged as a promising alternative. This abstract presents the application of multifocal pixel CO₂ laser technology, a novel approach characterized by pixelated energy delivery and precise depth control, for the treatment of female SUI, with a focus on its mechanism, clinical outcomes, and current adoption in China. Materials / method: This is a review and analysis of clinical applications and multicenter data. The therapeutic mechanism is based on the principle of fractional photothermolysis. This process aims to denature existing collagen, stimulate neocollagenesis and remodeling in the lamina propria, thereby thickening the tissue and enhancing urethral support. The standard treatment protocol involves 3-5 sessions, spaced one month apart, with each session lasting 5-10 minutes in an outpatient setting. Results: Clinical data collected from 105 hospitals in China involving 10,228 SUI patients demonstrated a significant overall efficacy rate of 95.69%. Subgroup analysis revealed near-complete efficacy (100%) in mild SUI, high efficacy (93.92%) in moderate SUI, and notable improvement (58.55%) even in severe cases. The primary outcomes include a marked reduction in leakage episodes, improved quality-of-life scores, and subjectively reported enhancement in vaginal tightness and lubrication. Conclusion: Multifocal pixel CO₂ laser therapy represents a safe, effective, and minimally invasive treatment option for female SUI, particularly for mild to moderate cases. Its core advantages lie in its precise depth control and pixelated energy delivery, which enable targeted collagen remodeling without damaging underlying structures. Supported by robust clinical data from China, this technology has become an important part of the SUI treatment landscape, offering a viable alternative for patients seeking non-surgical or minimally invasive solutions.