A fiber optical device suitable for treating a wide variety of medical conditions that involve shrinking or tightening of cartilaginous tissue, connective tissue, or muscle tissue comprises an optical fiber capable of laser energy delivery to a predetermined tissue site along with a biocompatible cooling fluid. Illustrative treatable medical conditions are female and male unitary incontinence, female stress urinary incontinence, gastro esophageal reflux disease, obesity, Type 2 diabetes, fecal incontinence, and the like. A preferred laser energy source is a CTH:YAG laser.