In this guide13 sections
- Key Points
- Is Vaginal Laser Safe?
- Vaginal Laser Side Effects
- Does Vaginal Laser Work for Stress Incontinence?
- Vaginal Laser for Incontinence: Reviews and Realistic Expectations
- Laser for Vaginal Laxity: What the Evidence Shows
- Does Vaginal Laser Work for Prolapse?
- How Does Vaginal Laser Compare With Other Treatments?
- What Happens During IntimaLase and IncontiLase Treatment?
- Vaginal Laser Treatment at Centre for Surgery
- Frequently Asked Questions
- Vaginal Laser Treatment in London
- References
Key Points
- Is vaginal laser safe? In clinical trials, side effects have been mostly mild and short-lived, and a 2025 Cochrane review found no major adverse events. NICE found no short-term safety concerns, but long-term safety data are inadequate.
- Vaginal laser side effects include warmth or discomfort during treatment, watery discharge, mild swelling or spotting for a day or two, and urinary symptoms. Burns, scarring and chronic pain have been reported with energy-based devices, which is why the US FDA issued a warning in 2018.
- Does vaginal laser work for incontinence? Trials disagree. Two sham-controlled Er:YAG trials found more women improved with laser than sham, while a double-blind trial of 144 women found no difference at six months.
- What the reviews say: a Cochrane review concluded laser may have little to no effect on stress incontinence in the short term, and a 2026 meta-analysis found a modest, short-term benefit, most consistent with non-ablative Er:YAG laser.
- Laser for vaginal laxity evidence: sexual function improved in observational studies, but the improvement was not confirmed in randomised controlled trials.
- Who it may suit: women with mild to moderate stress incontinence or mild laxity who want to avoid surgery, after pelvic floor training, with a normal smear and realistic expectations.
Vaginal laser treatment is marketed for loose vaginal tissue, bladder leaks, prolapse and dryness, and many women want to know two things before booking: is it safe, and does it actually work? Both questions have honest answers, and they are not the same answer. In the short term, vaginal laser appears safe. Whether it works is less certain, and depends on the problem being treated and on which trial you read.
This guide sets out the side effects, the regulatory warnings, and the results of the main sham-controlled trials, so that you can weigh up treatment with accurate information. At Centre for Surgery, vaginal laser treatment uses the Fotona SMOOTH Er:YAG laser, including IntimaLase for vaginal laxity and IncontiLase laser treatment for incontinence. For a wider view of every surgical and non-surgical option, see our guide to the types of vaginal rejuvenation.
Is Vaginal Laser Safe?
Across the randomised trials published so far, vaginal laser has had a good short-term safety record. The 2025 Cochrane review of vaginal lasers for stress urinary incontinence ↗, which pooled nine trials and 689 women, reported no major adverse events in either the laser or the sham groups[5]. A 2026 meta-analysis of sham-controlled trials of energy-based devices also found that adverse events were mild and transient[6].
What is missing is long-term data. Most trials follow women for six to twelve months, so the effect of repeated treatment over many years is not known.
What did the FDA warn about in 2018?
On 30 July 2018 the US Food and Drug Administration warned against the use of energy-based devices, including lasers and radiofrequency, to perform “vaginal rejuvenation” or cosmetic vaginal procedures[1], saying that safety and effectiveness for those uses had not been established. The warning was aimed at marketing that outstripped the evidence, and it cited reports of harms such as vaginal burns, scarring and pain. It is a good reason to have treatment only from a medically led team, after an examination.
What does NICE say about vaginal laser?
In 2021 NICE reviewed transvaginal laser therapy for stress urinary incontinence ↗ and for urogenital atrophy ↗. For both, it found no short-term safety concerns, but said evidence on long-term safety and efficacy is inadequate in quality and quantity, so the procedure should only be used with special arrangements for research. That guidance predates several of the trials described below.
Vaginal Laser Side Effects
The side effects reported in trials and in clinical practice are mostly mild:
- Warmth or discomfort during treatment. The vaginal lining has little pain sensation, so most women feel warmth rather than pain, although some find higher settings uncomfortable.
- Watery discharge, mild swelling or light spotting for 24 to 48 hours.
- Soreness like mild sunburn for up to 48 hours, particularly after treatment for dryness.
- Urinary symptoms such as frequency or discomfort, and occasionally a urinary infection.
- Not enough improvement, which is the commonest reason women are disappointed rather than a side effect as such.
Serious complications such as burns, lasting scarring or chronic pain are rare, and have mainly been linked to devices used outside their intended settings or by untrained operators. The risk is lowest when the laser is set and used by a trained clinician on healthy tissue.
Who should not have vaginal laser treatment?
Treatment is not suitable, or should be postponed, if you are pregnant or trying to conceive, have an active vaginal or urinary infection, have unexplained bleeding, or do not have a current normal cervical smear result. Laser is also not the right treatment for severe incontinence, more than mild prolapse, or laxity caused by separated muscle, where it is unlikely to help.
Does Vaginal Laser Work for Stress Incontinence?
Stress urinary incontinence is leaking when pressure in the abdomen rises, on coughing, sneezing, laughing, running or lifting. The aim of laser treatment, such as IncontiLase, is to firm the front vaginal wall that supports the urethra. Our guide to what causes urinary incontinence in women explains why the type of leak matters before any treatment is chosen. Here is what the main sham-controlled trials of the non-ablative Er:YAG laser found.
The trials that found a benefit
In a 2023 multicentre sham-controlled trial of 110 women ↗, two laser treatments a month apart led to treatment success on a one-hour pad test in 59% of women at six months, compared with 36% after a sham treatment[2]. A 2025 trial in three urogynaecology departments in the UK, Switzerland and Germany randomised 79 women with mild to moderate leaks to three sessions of laser or sham: 62.7% of the laser group had at least a 50% reduction in leakage at six months, compared with 18.2% after sham[4].
The trial that found no benefit
In a double-blind trial of 144 women in the American Journal of Obstetrics and Gynecology ↗, two Er:YAG laser treatments six weeks apart were no more effective than sham for curing or improving stress incontinence at six months[3]. Small differences seen at six weeks did not last.
What the systematic reviews conclude
When trials disagree, systematic reviews pool them. The 2025 Cochrane review concluded that vaginal lasers may have little to no effect on stress incontinence in the short term compared with sham, that any improvement in symptom scores may be too small for women to notice, and that the evidence is very uncertain[5]. The 2026 meta-analysis of ten sham-controlled trials found a statistically significant but modest improvement, strongest and most consistent for non-ablative Er:YAG laser, and noted that the effects were short-term[6].
Put simply: some women with mild to moderate stress incontinence do improve after Er:YAG laser, more than would be expected from a sham, but the size of the benefit is modest, not every trial agrees, and nobody yet knows how long it lasts.
Vaginal Laser for Incontinence: Reviews and Realistic Expectations
When people search for vaginal laser for incontinence reviews, they usually want to know what it is like and whether it helped other women. Patient experiences vary widely, which matches the trials. Women most likely to notice a difference have mild to moderate leaks of the stress type, have already tried pelvic floor exercises, and continue those exercises afterwards. Women with mainly urgency leaks, severe incontinence or significant prolapse are less likely to benefit.
A realistic expectation is fewer or smaller leaks, not a cure, with a course of two sessions a month apart and a possible yearly maintenance session. If leaks persist, the treatments with the strongest evidence are set out in NICE’s guideline on urinary incontinence and pelvic organ prolapse in women ↗, including supervised pelvic floor training and surgery.
Laser for Vaginal Laxity: What the Evidence Shows
Vaginal laxity is a feeling of looseness, usually after vaginal birth, often with reduced sensation during sex. IntimaLase heats the vaginal wall and opening in non-ablative SMOOTH mode, usually in three sessions four to six weeks apart.
The best summary of the evidence is a 2024 systematic review and meta-analysis of 38 studies of treatments for vaginal laxity. Sexual function scores improved after laser or radiofrequency in observational studies, but the improvement was not confirmed when only randomised controlled trials were analysed[7]. That pattern, better results in uncontrolled studies than in controlled ones, suggests part of the improvement women report comes from expectation and from natural recovery rather than from the laser itself.
Laser does not repair separated pelvic floor muscle or narrow a wide vaginal opening. For marked laxity, vaginoplasty is the treatment that makes a structural change, and our guide to loose vagina facts and myths explains how to tell the two situations apart. Our article on the benefits of IntimaLase covers what women who choose laser can realistically expect.
Does Vaginal Laser Work for Prolapse?
For mild to moderate prolapse, a 2024 randomised trial of 46 women compared Er:YAG laser with pelvic floor exercises. Both improved symptoms to a similar extent, but neither effect was durable, and by 24 months half of the laser group had asked for further treatment[8]. The laser device for that trial was provided by the manufacturer. At Centre for Surgery, ProlapLase is offered only for mild to moderate prolapse; more advanced prolapse needs a surgical assessment.
How Does Vaginal Laser Compare With Other Treatments?
Laser sits between exercise and surgery, and it works best when it is used in that order:
- Pelvic floor muscle training is the first treatment for stress incontinence and mild laxity. It is free, safe and effective when done properly. Our guide to ways to tighten your vagina explains how.
- Vaginal oestrogen is the first treatment for dryness and atrophy after menopause, as our guide to treatment options for vaginal atrophy describes.
- Vaginal laser is an option for mild symptoms that have not responded enough, or for women who want to avoid or delay surgery.
- Surgery gives the most reliable result for marked laxity (vaginoplasty), a wide or scarred opening (perineoplasty) or persistent incontinence.
For a full comparison of non-surgical options, see our guide to non-surgical vaginal rejuvenation.
What Happens During IntimaLase and IncontiLase Treatment?
Before treatment you have a consultation and examination, and treatment only goes ahead once a normal smear result is confirmed and any infection has cleared. No fasting or other preparation is needed.
A session takes about 15 to 30 minutes. A smooth handpiece is placed in the vagina and delivers short pulses of laser heat to the vaginal walls, or for IncontiLase mainly to the front wall beneath the urethra. No anaesthetic is needed. You can dress and return to work straight away, but should avoid sex for 72 hours. A course is usually two sessions a month apart for IncontiLase and three sessions four to six weeks apart for IntimaLase, with a yearly maintenance session sometimes recommended. Our guide to when you can have sex after laser vaginal tightening covers aftercare.
Vaginal Laser Treatment at Centre for Surgery
Centre for Surgery is a CQC-regulated private hospital at 95–97 Baker Street. Every patient has a face-to-face consultation and examination with a GMC-registered clinician before treatment, and we will tell you if laser is unlikely to help, or if pelvic floor physiotherapy, vaginal oestrogen or surgery would be a better choice. Treatment uses the Fotona SMOOTH Er:YAG laser in four protocols: IntimaLase, IncontiLase, ProlapLase and RenovaLase. If surgery is more appropriate, it is carried out at the same hospital under local anaesthetic with sedation or TIVA, and the surgeon who assesses you performs your surgery. The consultation fee is redeemable against treatment, and finance is available.
Frequently Asked Questions
What are the drawbacks of vaginal laser therapy?
The main drawbacks are uncertain effectiveness and the need for repeat treatment. Trials disagree on how well it works, any benefit tends to be modest, and it may fade, so a yearly maintenance session is often suggested. It cannot repair separated muscle or remove tissue. Long-term safety data are limited.
Does vaginal laser treatment hurt?
Most women find it comfortable and no anaesthetic is needed. The vaginal lining has few pain fibres, so the usual sensation is warmth. Some women feel brief discomfort at higher settings or near the entrance, and the clinician can adjust the settings during treatment.
Can vaginal laser cause scarring?
Scarring is rare. The non-ablative Er:YAG mode heats the tissue without breaking the surface, which reduces the risk. Burns and scarring have been reported with energy-based devices, mainly where they were used outside their intended settings, which is one reason to choose a medically led clinic.
What is the number one treatment for urinary incontinence?
For stress incontinence, the first treatment is supervised pelvic floor muscle training for at least three months, alongside simple measures such as managing weight, constipation and caffeine. For urgency incontinence, bladder training comes first. Laser, bulking injections and surgery are considered if these do not help enough.
What is the latest treatment for female incontinence?
Newer options include vaginal laser, urethral bulking injections and magnetic chair stimulation of the pelvic floor. Of these, laser has the most trial evidence, but results are mixed. Established surgical treatments, such as colposuspension or a sling made from your own tissue, remain the most effective for severe stress incontinence.
When can you have sex after vaginal laser?
You should avoid sex for 72 hours after each session so the treated tissue can settle. There are no other restrictions on everyday activity, work or exercise.
Is vaginal laser available on the NHS?
Not routinely. NICE recommends that transvaginal laser for stress incontinence and urogenital atrophy is only used with special arrangements for research, so it is generally offered privately. Pelvic floor physiotherapy and incontinence surgery are available on the NHS.
How long does vaginal laser last?
Any improvement is not permanent, and how long it lasts varies from woman to woman. Most trials report results at six to twelve months, and a 2024 prolapse trial found the benefit was not durable at two years. Some women who notice an improvement choose a yearly maintenance session.
Vaginal Laser Treatment in London
If you are considering laser for bladder leaks or vaginal laxity, a consultation will establish whether it is likely to help and what the alternatives are. Find out more about IncontiLase laser treatment for stress incontinence and vaginal laser treatment at Centre for Surgery.
Phone: 020 7993 4849 | Address: 95–97 Baker Street, Marylebone, London W1U 6RN
Contact us to schedule a consultation
References
- Phillips C, Hillard T, Salvatore S, Toozs-Hobson P, Cardozo L. Lasers in gynaecology. European Journal of Obstetrics, Gynecology, and Reproductive Biology 2020;251:146–155. doi:10.1016/j.ejogrb.2020.03.034 ↗
- O’Reilly BA, Viereck V, Phillips C, et al. Vaginal erbium laser treatment for stress urinary incontinence: a multicenter randomized sham-controlled clinical trial. International Journal of Gynaecology and Obstetrics 2023;164(3):1184–1194. doi:10.1002/ijgo.15222 ↗
- Lee P, Perruzza D, Edell H, et al. Double-blind randomized controlled trial of Er:YAG vaginal laser to treat female stress urinary incontinence. American Journal of Obstetrics and Gynecology 2024;232(6):541.e1–541.e12. doi:10.1016/j.ajog.2024.11.021 ↗
- Phillips C, Shah G, Gamper M, Kuszka A, Chandrakumaran K, Viereck V. Vaginal erbium laser for the treatment of mild-to-moderate stress urinary incontinence: a multicentre randomised sham-controlled trial. BJOG 2025;133(4):609–617. doi:10.1111/1471-0528.70080 ↗
- Ippolito GM, Crescenze IM, Sitto H, et al. Vaginal lasers for treating stress urinary incontinence in women. Cochrane Database of Systematic Reviews 2025;7(7):CD013643. doi:10.1002/14651858.CD013643.pub2 ↗
- Lukanović D, Shah G, Matjašič M, Phillips C. The use of energy-based devices for the treatment of stress urinary incontinence: a systematic review and meta analysis of the randomised sham-controlled trials. International Urogynecology Journal 2026;37(9):2779–2790. doi:10.1007/s00192-026-06604-9 ↗
- Pereira GMV, Cartwright R, Juliato CRT, Domoney C, Iglesia CB, Brito LGO. Treatment of women with vaginal laxity: systematic review with meta-analysis. The Journal of Sexual Medicine 2024;21(5):430–442. doi:10.1093/jsxmed/qdae028 ↗
- Page AS, Borowski E, Bauters E, Housmans S, Van der Aa F, Deprest J. Vaginal erbium laser versus pelvic floor exercises for the treatment of pelvic organ prolapse: a randomised controlled trial. European Journal of Obstetrics, Gynecology, and Reproductive Biology 2024;303:165–170. doi:10.1016/j.ejogrb.2024.10.042 ↗
