Leaking with a cough, a sneeze or exercise is Alma's second indication for FemiLift, and a use where the sham-controlled trials are split, so we give each result on both sides and NICE's first-line treatment alongside. Every treatment is given by Dr Marie Duggan, GMC 7488383, at Femilift Clinic London, 130 Harley Street, London, W1G 7JU, after a free consultation and examination.
What the trials found
- No difference from sham after a first course, three trials: 101 women in 2022, in whom the incontinence persisted at three months in 98% after the laser and 96% after sham; 59 women in 2023; and 37 women in 2025.
- A gain over sham, one trial: 114 women in 2022, with 45.2% against 14.0% continent on the trial's objective tests over twelve months. At four years the authors reported that continence lasted 26.7 months on average after the laser against 8.21 after sham, and that continence rates declined over time. The same trial compared laser with radiofrequency, and both did significantly better than sham with similar results.
- The 2025 Cochrane review, nine trials and 689 women: vaginal lasers "may have little to no effect" on stress incontinence in the short term, with very low certainty. Over the medium term it found "there may be more continent women among those who received vaginal laser compared to those who received sham", again on very uncertain evidence.
- Against pelvic floor training, 94 women in 2026: the laser was non-inferior to pelvic floor muscle training at twelve months.
- The FemiLift series, 59 women, no comparison group: the pad weight that measures leakage fell from 35.45 g to 12.47 g at the third treatment and was 23.06 g at twelve months. The best results came between three and six months, and maintenance was suggested at six to twelve months.
What NICE says
NICE guidance HTG581, on transvaginal laser for stress urinary incontinence, says the evidence "does not show any short-term safety concerns" and that "this procedure should only be used in the context of research". It notes that "continuation of pelvic floor exercises is important". NICE's guideline on urinary incontinence says to offer a trial of supervised pelvic floor muscle training of at least three months' duration as first-line treatment.
How we plan it
In our practice Dr Marie Duggan examines you, with a smear test first, and gives you the statements above and the trial results, and pelvic floor training continues whatever you decide about the laser. In our practice, anyone with a prolapse or a symptom that needs a diagnosis first is referred for it. The course is two or three sessions initially in Alma's words, typically three at four to six weeks apart in NICE's, with the plan set at the consultation. The laser or physiotherapy page weighs the first-line option, and the full guide covers the rest. The price is in writing at a free consultation, with a price match on any comparable written quote.
