School of Medical Science, University of Campinas (UNICAMP), Campinas, Brazil.
Department of Obstetrics and Gynecology, School of Medicine, University of Campinas (UNICAMP), Rua Alexander Fleming, 101, Cidade Universitária Zeferino Vaz, Campinas, SP, 13083-881, Brazil.
Int Urogynecol J. 2023 Jun;34(6):1139-1152. doi: 10.1007/s00192-022-05419-8. Epub 2023 Jan 21.
Urinary incontinence (UI) affects approximately 50% of adult women worldwide and is associated with declining sexual function (SF). Energy-based devices emerged as a minimally invasive alternative treatment. Nevertheless, their effect on sexuality is uncertain. We hypothesize that the UI energy treatment can lead to sexual function improvement.
A search was performed in PubMed, Cochrane Library, Web of Science, Embase, and Scopus for randomized clinical trials (RCTs) and nonrandomized studies of intervention, which treated incontinent women using energy, with UI and sexual function (SF) as outcomes. Severe comorbidities, pelvic organ prolapse (POP)> grade 2, and use of medication to treat UI or that affects SF were excluded. Quality assessment and meta-analysis were performed.
From 322 articles, 11 RCTs were included for qualitative analysis. UI symptoms improved in all studies. Regarding SF, RCT with premenopausal women showed improvement in SF in the Er:Yag group (Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 and Female Sexual Function Index). A prospective study showed improvement in SF independent of the grade of SUI. RF showed benefits for SF but was not superior to pelvic floor muscle training. One nonrandomized study of intervention with a High-Intensity Focused Electromagnetic Field showed significant improvement of SF in the Golombok Rust Inventory of Sexual Satisfaction total score, a decline in pain and dissatisfaction domains. Meta-analysis with 4 RCTs and 2 nonrandomized studies found no difference between groups (0.26 (95% CI -0.67 to 1.20, and -0.74 (95% CI -3.78 to 2.30) respectively).
This meta-analysis did not confirm that energy equipment improved the SF of women with UI.
尿失禁（UI）影响全球约 50%的成年女性，与性功能（SF）下降有关。能量设备作为一种微创的替代治疗方法出现。然而，其对性行为的影响尚不确定。我们假设 UI 能量治疗可以改善性功能。
在 PubMed、Cochrane 图书馆、Web of Science、Embase 和 Scopus 中进行了检索，以查找使用能量治疗尿失禁女性的随机临床试验（RCT）和干预性非随机研究，将尿失禁和性功能（SF）作为结果。排除严重合并症、盆腔器官脱垂（POP）>2 级以及用于治疗 UI 或影响 SF 的药物。进行了质量评估和荟萃分析。
从 322 篇文章中，纳入了 11 项 RCT 进行定性分析。所有研究均显示 UI 症状改善。关于 SF，在绝经前女性的 RCT 中，Er:Yag 组的 SF 改善（盆腔器官脱垂/尿失禁性问卷-12 和女性性功能指数）。一项前瞻性研究表明，SF 的改善与 SUI 的严重程度无关。RF 对 SF 有益，但并不优于盆底肌肉训练。一项高强度聚焦电磁场干预的非随机研究显示，SF 的 Golombok Rust 性满意度总评分显著提高，疼痛和不满领域下降。4 项 RCT 和 2 项非随机研究的荟萃分析发现两组之间无差异（分别为 0.26（95%CI -0.67 至 1.20）和 -0.74（95%CI -3.78 至 2.30））。
这项荟萃分析并未证实能量设备能改善 UI 女性的 SF。
