Gonzalez et al (2018) examined the long-term effect of thermo-ablative fractional CO2 laser (TACO2L) as an alternative treatment for early stages of stress urinary incontinence (SUI) in post-menopausal women with genitourinary syndrome of menopause. A total of 161 post-menopausal patients (age of 53.38 ± 5.1 years, range of 45 to 65 years) with a clinical diagnosis of mild SUI were prospectively enrolled in the study. Patients received 1 treatment with TACO2L every 30 to 45 days, each treatment comprising 4 sessions, followed in all patients by a yearly treatment session at 12, 24 and 36 months. SUI was evaluated using the International Continence Society 1-hour pad test and the ICIQ-UI SF before and after TACO2L treatment. TACO2L treatment was associated with a significant improvement in ICIQ-UI SF scores and 1-hour pad weight test at 12 months (both p < 0.001), 24 months (both p < 0.001) and 36 months (both p < 0.001). Improvements were maintained for up to 36 months without the need for any further intervention. The results were confirmed by significant histological changes related to trophic restoration of the vagina, responsible for extrinsic and intrinsic mechanisms involved in urinary continence. The authors concluded that these findings suggested that TACO2L was a safe and efficient novel treatment strategy in patients with mild SUI. These researchers stated that further investigation to confirm the long-term results presented here is still needed. These researchers stated that this was a prospective, non-randomized study of an observational nature with no control group. Since all patients enrolled were relatively young (45 to 65 years), the results of this particular study could not be translated into older populations.