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Microablative radiofrequency versus pelvic floor muscle training for stress urinary incontinence: a randomized controlled trial

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A Commentary to this article was published on 20 May 2021

Abstract

Introduction and hypothesis

The efficacy of radiofrequency (RF) in stress urinary incontinence (SUI) is as yet unknown. The aim was to compare the effect of fractional microablative RF and pelvic floor muscle training (PFMT) against the combination of both therapies (RF + PFMT) in the SUI and on genitourinary syndrome (GSM).

Methods

This was a three-arm randomized clinical trial including 117 climacteric women with SUI. In group 1 the treatment consisted of three monthly sessions of RF; in group 2 it was 12 weekly PFMT sessions; in group 3 it was RF + PFMT simultaneously. Assessments at baseline and 30 days after the end of therapy were conducted using validated questionnaires and scales for urinary, vaginal, and sexual functions and cytology for vaginal trophy.

Results

Urinary scores improved significantly in all three groups post-treatment (p < 0.001) with a higher improvement in the RF + PFMT group (p = 0.002). One-hour pad test results were equal in the three groups. Vaginal symptoms showed an incremental improvement in RF (p < 0.007), and vaginal laxity showed a similar improvement in the three groups (p = 0.323). Vaginal Health Index score was more significant in RF and RF + PFMT groups. Sexual function improved in RF and PFMT.

Conclusions

The association between RF and PFMT showed significant improvement in the SUI symptoms assessed by questionnaire. The vaginal symptoms and dryness showed greater improvement in the RF treatment and vaginal laxity showed similar improvement in the three groups. The combination of RF and PFMT in sexual function did not show benefits superior to those achieved by the therapies alone.

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Abbreviations

FSFI:

Female Sexual Function Index

GSM:

Genitourinary syndrome

ICIQ-SF:

International Conference on Incontinence Questionnaire Short Form

ICIQ-VS:

International Consultation on Incontinence Questionnaire Vaginal Symptoms

PFMT:

Pelvic floor muscle training

REBEC:

Brazilian Registry of Clinical Trials

RF:

Radiofrequency

RF + PFMT:

Combination of radiofrequency with pelvic floor muscle training

SUI:

Stress urinary incontinence

VAS:

Visual analog scale

VHI:

Vaginal Health Index

VMI:

Vaginal Maturation Index

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Financial disclaimer

This study was funded by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Grant CAPES, code 001.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Campinas Faculty of Medical Sciences, Campinas, SP, Brazil

    Helena Slongo & Cássia R. T. Juliato

  2. Department of Surgery, University of Campinas Faculty of Medical Sciences, Campinas, SP, Brazil

    Ana Lygia B. Lunardi & Cássio L. Z. Riccetto

  3. Statistics Department, University of Campinas Faculty of Medical Sciences, Campinas, SP, Brazil

    Helymar C. Machado

  4. Department of Gynecology and Obstetrics, University of Campinas (UNICAMP), Rua Alexander Fleming, 101, Cidade Universitária Zeferino Vaz, Campinas, SP, 13083881, Brazil

    Cássia R. T. Juliato

Authors
  1. Helena Slongo
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  2. Ana Lygia B. Lunardi
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Contributions

S. Helena: project development, data collection, manuscript writing; B.L. Anna Lygia: project development, data collection, manuscript writing; L.Z.R. Cássio: project development, manuscript writing; C.M. Helymar: statistics, manuscript writing; R.T.J. Cássia: project development, manuscript writing.

Corresponding author

Correspondence to Cássia R. T. Juliato.

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Trial registration: registered in REBEC (Registro Brasileiro de Ensaios Clínicos; Brazilian Registry of Clinical Trials) under number RBR-9v3q33.

http://www.ensaiosclinicos.gov.br/rg/RBR-9v3q33/. This study was approved by the Institutional Review Board under the number CAAE 97464918.4.0000.5405

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Slongo, H., Lunardi, A.L.B., Riccetto, C.L.Z. et al. Microablative radiofrequency versus pelvic floor muscle training for stress urinary incontinence: a randomized controlled trial. Int Urogynecol J 33, 53–64 (2022). https://doi.org/10.1007/s00192-021-04758-2

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  • DOI: https://doi.org/10.1007/s00192-021-04758-2

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