Adverse effects of non-ablative radiofrequency in women with urinary symptoms of stress urinary incontinence. A scoop review

Dória M1, Matos J C1, Leony J C1, Matos Y C C1, Brasil C1, Lemos A1, Porto M1, Gomes T1, Lordelo P1

Research Type

Basic Science / Translational

Abstract Category

Conservative Management

Abstract 740
Non Discussion Abstracts
Scientific Non Discussion Abstract Session 36
Female Stress Urinary Incontinence New Devices
1. Pelvic Floor Care Center (CAAP), Bahiana School of Medicine and Public Health
Links

Abstract

Hypothesis / aims of study
Non-ablative radiofrequency therapy differs from ablative therapy by promoting collagen denaturation at a microscopic level using a milder temperature, sparing tissue from its destruction and necrosis.(1) In studies evaluating the efficacy of this long-term therapy, a functional gain without anatomical distortion can be observed, due to the reduction of local tissue compliance without change of thickness. (2) This study aims to evaluate the efficacy and outcome of non-ablative radiofrequency techniques in women with stress urinary incontinence with an emphasis on its adverse effects.
Study design, materials and methods
This is a SCOPE study that seeks to provide an overview of the outcomes of radiofrequency therapy whose search inclusion factors include women with complaints of urinary incontinence, older than 18 years and treated with non- ablative. The search was carried out comprehensively in several databases: LILACS, PUBMED, MEDLINE, COCHRANE, CAPES. COCHRANE, CAPES.
Results
Of the studies found that were related to the effects of non-ablative radiofrequency, in short, radiofrequency treatment showed a significant reduction of urinary symptoms. One of the studies showed a significant improvement measured by the International Consulation on Incontinence Short Form (ICIQ-SF) and Urogenital Distress Inventory (UDI-6 (p <0.05). scale and significant reduction of its baseline. However, one of these studies did not show a sustained in the 12 months and subsequent more RF sessions. Besides these, the analysis of a prospective, multicentric and non randomized trial showed a reduction in the frequency of incontinence Urinary from 2.15 ± 1.03 to 1.0 ± 0.78 after the last session and after a month reduced to 0.44-0.55. The frequency, volume and interference in Quality of Life significantly reduced. After treatment, 81% of the patients reported were satisfied or very satisfied with treatment for SUI. In this same study, no patient reported dissatisfaction with the treatment of radiofrequency. Finally, a pilot study whose the main outcome was based on the evaluation of the Pad-Test, that at the end of the first month, all patients reduced the value of the Pad Test at the end of treatment. Most of women (around 70%) reduced urinary loss by performing the implementation of the defined protocol Pad Test while 90% of the women reported being satisfied with treatment. There was a reduction of the pad test until the 3 (p <0.05). In all studies, no observed adverse effects by the participant or observed.
Interpretation of results
The results were in agreement with the current literature, where good tolerability and a reduction of urinary stress loss were observed in female patients submitted to non-ablative radiofrequency therapy. (3)
Concluding message
Therefore, radiofrequency therapy showed a significant improvement in the incontinence profile, being reflected through the Pad-Test, ICIQ-IU, ICIQ-SF, EVA, UDI-6 and Likert Satisfaction Scale. In addition, RF proved to be safe, with few or no side effects, evidencing a non-invasive treatment alternative.
Figure 1
References
  1. Rovner ES, Wein AJ. Treatment options for stress urinary incontinence. Rev Urol [Internet]. 2004 [citado 15 de outubro de 2017];6 Suppl 3(Suppl 3):S29-47. Available at: http://www.ncbi.nlm.nih.gov/pubmed/16985862;
  2. Millheiser LS, Pauls RN, Herbst SJ, Chen BH. Radiofrequency Treatment of Vaginal Laxity after Vaginal Delivery: Nonsurgical Vaginal Tightening. J Sex Med [Internet]. setembro de 2010 [Acesso em 03 de abril de 2018];7(9):3088–95. Available at: http://linkinghub.elsevier.com/retrieve/pii/S1743609515331593;
  3. Appell RA, Singh G, Klimberg IW, Graham C, Juma S, Wells WG, et al. Nonsurgical, radiofrequency collagen denaturation for stress urinary incontinence: retrospective 3-year evaluation. Expert review of medical devices. 2007; v. 4, n. 4, p. 455-461.
Disclosures
Funding National Foundation for the Development of Higher Education (Funadesp) Clinical Trial No Subjects None