Slongo Helena, Lunardi Ana Lygia B, Riccetto Cássio L Z, Machado Helymar C, Juliato Cássia R T
Department of Obstetrics and Gynecology, University of Campinas Faculty of Medical Sciences, Campinas, SP, Brazil.
Department of Surgery, University of Campinas Faculty of Medical Sciences, Campinas, SP, Brazil.
Int Urogynecol J. 2022 Jan;33(1):53-64. doi: 10.1007/s00192-021-04758-2. Epub 2021 Apr 10.
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).
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.
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.
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.
射频（RF）治疗压力性尿失禁（SUI）的疗效尚不清楚。目的是比较分次微消融射频与盆底肌肉训练（PFMT）联合治疗（RF + PFMT）对SUI及泌尿生殖综合征（GSM）的效果。
这是一项三臂随机临床试验，纳入117名患有SUI的更年期女性。第1组治疗包括每月3次射频治疗；第2组为每周12次PFMT治疗；第3组为同时进行RF + PFMT治疗。在基线和治疗结束后30天，使用经过验证的问卷和量表评估泌尿、阴道和性功能，以及阴道细胞涂片检查阴道萎缩情况。
所有三组治疗后尿失禁评分均显著改善（p < 0.001），RF + PFMT组改善更明显（p = 0.002）。三组的1小时尿垫试验结果相同。阴道症状在射频治疗组有渐进性改善（p < 0.007），三组阴道松弛度改善情况相似（p = 0.323）。阴道健康指数评分在射频治疗组和RF + PFMT组更显著。性功能在射频治疗组和PFMT组有所改善。
射频与PFMT联合治疗在通过问卷评估的SUI症状方面显示出显著改善。阴道症状和干燥在射频治疗组改善更明显，三组阴道松弛度改善情况相似。射频与PFMT联合治疗在性功能方面并未显示出优于单独治疗的益处。
