The Integral Theory states the urgency may also be caused by the laxity of uterosacral ligaments and Pubourethal as well. Because in this device the energy flows form the probe to the plate put on the suprapubic region (PUL) or sacral region (USL) it addrees all the length of these ligaments, restoring the support of the pelvic organs.
In our study with RF we obtained a significant improvement in the urgency ( p<0,0001) in women after 5 sessions of RF with increase in Vaginal health index (VHI) scores (p< 0,0001) with concomitant improvement in overactive bladder and a good level of satisfaction for the procedure . Starting from these clinical observations,we decided to evalute the role of non ablative RF in in the treatment of OAB symptoms in post-menopausal women.
The enrolled patients for this study were in menopause with OAB symptoms from november 2022 to november 2023.The inclusion criteria consisted of menopausal status with GUS symptoms and diagnosis of OAB syndrome Exclusion criteria at study were considered:clinically significant bladder outflow obstruction,significant post-void residual PVR < 200 ml,associated SUI ,diabetic neuropathy,use concomitant urinary incontinence medications, UTI,active genital infections,previous pelvic radiation therapy,current malignant disease of the pelvic organ prolapse POP stage > ll HWS classification and \or the use of HRT (systemic or local) up to months before the study recruiment period,women who were using psycotropic drugs were escluted.

The symptoms was also evaluated at T0 and T1 (vaginal itching, vaginal burning, vaginal dryness and dyspareunia) using a visual analog scale (VAS), which is based on a score from 1 to 10, where 1 indicates the absense of symptoms (“as bad as it could be”).
At T0 and T1, eligible patients adduced a micturition diary, which was to be completed during the 3 days preceding the visit.In the diary , patients were asked in specify the number of micturitions,number of urgency episodes and number of incontinence episodes,for every considered day..
Overactive bladder symptoms were assessed using the validated Overactive Bladder Quetionnarie Short Form (OAB-Q SF).
Eventual adverse events which occurred or were referred by patients (during, immediately after treatment sessions, and until the end of study) were recorded. We considered any disorder, disconfort local and general, arising in relation to the non ablative RF as an adverse event.

In the study period, 30 patients were enrolled. Demographic characteristics are reported in table 1 All patients included into the study completed the study-protocol and carried out the final evalueted at T1 .We observed a statistically significant improvement in VAS parameters concerning dryness (8\3 vs 2\1.25; p<0.0001), burning (8/2.25 vs. 1/1; p<0.0001), itching (8/2 vs. 1/2; p<0.0001), and dyspareunia (9/5/1.25 vs. 2/1.25; p<0.0001) (Figure 2A).

We also reported a significant improvement in VHI at T1 (11/3 vs. 22/3.25; p<0.0001) (Figure 2B), in micturition diary (10/2.5 vs. 6/2; p<0.0001) (Figure 3A), in number urge episodes (3/1; p<0.0001) (Figure 3B) and in OAB-q (18.5/4.25 vs. 8/2.25; p<0.0001) (Figure 4A). Nine of the 30 patients suffered from incontinence episodes, and had improved at T1 (3/1 vs. 1/1.5 episodes in 24 h; p<0.0001) (Figure 4B).

No significant differences were observed between patients the sessions for the same patients. No adverse events due to non ablative RF treatment occurred. In no case was it necessary to stop the procedure because of patient pain or intolerance. No local therapies were prescribed to any patient after the sessions of RF treatment.