Radiofrequência transvaginal não ablativa no tratamento da incontinência urinária e síndrome geniturinária da menopausa: estudo clínico, cego, controlado e randomizado

Abstract

Introduction and hypothesis: Female stress urinary incontinence is a prevalent condition and conservative treatment options are needed. The effectiveness of radiofrequency in stress urinary incontinence is still unknown. The aim of was to compare the effect of non-ablative transvaginal radiofrequency and pelvic floor muscle training on stress urinary incontinence and genitourinary syndrome of menopause. Methods: Fifty-nine post-menopausal women with stress urinary incontinence were randomized in this 2-arm, blinded, controlled trial into radiofrequency and sham control groups, both associated with pelvic floor muscle training, with monthly treatment sessions for 3 months and a 30-day follow-up after the last session. The primary objective was: subjective improvement of stress urinary incontinence, assessed through quality of life questionnaires (ICIQ-SF and KHQ). Validated Questionnaires and scales for sexual function, symptoms of genitourinary syndrome of menopause, assessment of pelvic floor muscle strength and vaginal pH were also applied. The sample size was calculated to provide 80% power to identify a 20% difference between groups, p < 0.05. Results: Scores improved clinically and statistically significantly in both groups after treatment (p time < 0.001, p interaction=0.318), but there was no difference with respect to interaction over time, there was an increase in pelvic floor muscle contraction strength in both groups, but also without significance in the interaction analysis (p time<0.001, p interaction=0.571). Sexual function did not change significantly in the groups. The radiofrequency group showed significant improvement in symptoms of vaginal dryness and vulvar burning sensation (p=0.012 and p=0.018, respectively). Conclusions: The use of non-ablative transvaginal radiofrequency associated with pelvic floor muscle strengthening exercises has not been shown to be superior to exercise alone, but some secondary benefits for the management of genitourinary syndrome of menopause were found, such as decreased vaginal dryness and vulvar burning sensation, which also results in increased quality of life for women undergoing treatment. [resumo fornecido pelo autor]