New concept for treating female stress urinary incontinence with radiofrequency

Patrícia Lordelo, Andrea Vilas Boas, Danielle Sodré, Amanda Lemos, Sibele Tozetto, Cristina Brasil, Patrícia Lordelo, Andrea Vilas Boas, Danielle Sodré, Amanda Lemos, Sibele Tozetto, Cristina Brasil

Abstract

Purpose: To evaluate the clinical response and adverse effects of radiofrequency on the urethral meatus in the treatment of stress urinary incontinence in women.

Materials and methods: This phase one study included ten women with Stress Urinary Incontinence (SUI). The evaluation consisted of 1 hour Pad tests to quantify urine loss and to assess the degree of procedure satisfaction by using the Likert scale. To evaluate safety, we observed the number of referred side effects.

Results: Average age was 53.10 years±7.08 years. In assessing the final Pad Test, 70% showed a reduction and 30% a worsening of urinary loss. Using the Pad Test one month later, there was a reduction in all patients (p=0.028). The degree of satisfaction was 90% and no side effects have been observed. One patient reported burning sensation.

Conclusion: The treatment of SUI with radiofrequency on the urethral meatus has no adverse effects, being a low risk method that reduces urinary loss in women. However, to increase the validity of the study, larger clinical trials are warranted.

Keywords: Pulsed Radiofrequency Treatment; Urinary Incontinence, Stress; Women.

Conflict of interest statement

Conflict of interest: None declared.

Copyright® by the International Brazilian Journal of Urology.

Figures

Figure 1. Details of the electrodes used…
Figure 1. Details of the electrodes used in the radiowfrequency apparatus Spectra G3 Tonederm®.
Figure 2. Demonstration of application of non-ablative…
Figure 2. Demonstration of application of non-ablative radiofrequency in external urethral meatus.
Figure 3. Comparison of mean urinary loss…
Figure 3. Comparison of mean urinary loss in grams (g) Pad Test at the begginning-, end-, and after one-, two- and three months of treatment.

References

    1. Tähtinen RM, Cartwright R, Tsui JF, Aaltonen RL, Aoki Y, Cárdenas JL, et al. Long-term Impact of Mode of Delivery on Stress Urinary Incontinence and Urgency Urinary Incontinence: A Systematic Review and Meta-analysis. Eur Urol. 2016;70:148–158.
    1. Maral I, Ozkardeş H, Peşkircioğlu L, Bumin MA. Prevalence of stress urinary incontinence in both sexes at or after age 15 years: a cross-sectional study. J Urol. 2001;165:408–412.
    1. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology in lower urinary tract function: report from the standardisation subcommittee of the International Continence Society. Urology. 2003;61:37–49.
    1. Felde G, Ebbesen MH, Hunskaar S. Anxiety and depression associated with urinary incontinence. A 10-year followup study from the Norwegian HUNT study (EPINCONT) Neurourol Urodyn. 2017;36:322–328.
    1. Lapitan MC, Cody JD. Open retropubic colposuspension for urinary incontinence in women. Cochrane Database Syst Rev. 2012;6 CD002912.
    1. Petros P. The integral system. Cent European J Urol. 2011;64:110–119.
    1. Fleischmann N, Flisser AJ, Blaivas JG, Panagopoulos G. Sphincteric urinary incontinence: relationship of vesical leak point pressure, urethral mobility and severity of incontinence. J Urol. 2003;169:999–1002.
    1. Fitzgerald MP, Mollenhauer J, Hale DS, Benson JT, Brubaker L. Urethral collagen morphologic characteristics among women with genuine stress incontinence. Am J Obstet Gynecol. 2000;182:1565–1574.
    1. Herman RM, Berho M, Murawski M, Nowakowski M, Ryś J, Schwarz T, et al. Defining the histopathological changes induced by nonablative radiofrequency treatment of faecal incontinence–a blinded assessment in na animal model. Colorectal Dis. 2015;17:433–440.
    1. Appell RA, Juma S, Wells WG, Lenihan JP, Klimberg IW, Kanellos A, et al. Transurethral radiofrequency energy collagen micro-remodeling for the treatment of female stress urinary incontinence. Neurourol Urodyn. 2006;25:331–336.
    1. Sand PK, Owens GM, Black EJ, Anderson LH, Martinson MS. Cost effectiveness of radiofrequency microremodeling for stress urinary incontinence. Int Urogynecol J. 2014;25:517–523.
    1. Elser DM, Mitchell GK, Miklos JR, Nickell KG, Cline K, Winkler H, et al. Nonsurgical transurethral collagen denaturation for stress urinary incontinence in women: 12-month results from a prospective long-term study. J Minim Invasive Gynecol. 2009;16:56–62.
    1. Ferreira CH, Barbosa PB, de Oliveira Souza F, Antônio FI, Franco MM, Bø K. Inter-rater reliability study of the modified Oxford Grading Scale and the Peritron manometer. Physiotherapy. 2011;97:132–138.
    1. Lordêlo P, Leal MR, Brasil CA, Santos JM, Lima MC, Sartori MG. Radiofrequency in female external genital cosmetics and sexual function: a randomized clinical trial. Int Urogynecol J. 2016;27:1681–1687.
    1. Gomez-Tames J, Fukuhara Y, He S, Saito K, Ito K, Yu W. A human-phantom coupling experiment and a dispersive simulation model for investigating the variation of dielectric properties of biological tissues. Comput Biol Med. 2015;61:144–149.
    1. Millheiser LS, Pauls RN, Herbst SJ, Chen BH. Radiofrequency treatment of vaginal laxity after vaginal delivery: nonsurgical vaginal tightening. J Sex Med. 2010;7:3088–3095.
    1. Kang D, Han J, Neuberger MM, Moy ML, Wallace SA, Alonso-Coello P, et al. Transurethral radiofrequency collagen denaturation for the treatment of women with urinary incontinence. Cochrane Database Syst Rev. 2015;3 CD010217.
    1. Hantash BM, Ubeid AA, Chang H, Kafi R, Renton B. Bipolar fractional radiofrequency treatment induces neoelastogenesis and neocollagenesis. Lasers Surg Med. 2009;41:1–9.
    1. Rechberger T, Postawski K, Jakowicki JA, Gunja-Smith Z, Woessner JF., Jr Role of fascial collagen in stress urinary incontinence. Am J Obstet Gynecol. 1998;179:1511–1514.
    1. Coombs S, Smith I. The Hawthorne effect: Is it a help or hindrance in social science research? Change: Transformations in Education. 2003;6(1):97–111.
    1. Haga N, Yanagida T, Yabe M, Akaihata H, Hata J, Sato Y, et al. Timing of Urinary Pad Exchanges Was the Most Important Factor Affecting Quality of Life in the Early Postoperative Period After Robot-Assisted Laparoscopic Radical Prostatectomy. J Endourol. 2015;29:1044–1051.
    1. Stach-Lempinen B, Kirkinen P, Laippala P, Metsänoja R, Kujansuu E. Do objective urodynamic or clinical findings determine impact of urinary incontinence or its treatment on quality of life? Urology. 2004;63:67–71.

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