RF in the Treatment OAB in UUI- a Prospective Randomized Placebo Controlled Study

Overview

Until now, OAB with or without UUI has been treated mainly in two ways: with behavioral methods and/or patient education or using antimuscarinic drugs and/or beta 3 adrenergic receptor agonists. Unfortunately, the drugs might cause side effects in some women or were insufficiently effective, so the patients abandoned them. Methods In prospective, randomized, placebo controlled study, 80 women were enrolled, using radiofrequency in treating OAB and UUI. Based on ICIQ-OAB, ICIQ-OAB QoL, and ICIQ-FLUTSsex questionnaires, severity of OAB symptoms, QoL and detailed evaluation of female sexual matters associated with their lower urinary tract symptoms. RF was applied 4 times for 20 minutes, once a week. Two week after the completion of the treatment,as well as 3, 6 and 12 months, the level of OAB and UUI was reassessed and processed it statistically and evaluated the treatment effect.

Criteria for inclusion in the study Women who have clear signs of OAB was included in the study. Also, those women who did not use drugs for the treatment of OAB (antimuscarinics/beta-3 agonists), were included. Those women who have taken drugs for the treatment of OAB in the past, but stopped (side effects, ineffectiveness) and at least 3 months have passed since the last treatment, were also included in the study. Exclusion criteria from the study Inserted heart pacemaker, unexplained bleeding from the vagina, inflammation of the vagina and/or uterus or uterine appendages. Bacterial or viral infection, impaired immune system, sclerodermia, radiation treatment, burns in the treatment area. Women with stress urinary incontinence (SUI) or mixed urinary incontinence were not included in the study. Radiofrequency in the treatment of urinary incontinence In the study, the radiofrequency device Capenergy model C 100 with an upgrade to the urogynecological model C 500, was used. This device has a 1-channel capacitive and resistive probe for individual use. The mechanism of action is electrotherapy with the help of high-frequency electricity (TECAR). The use of electromagnetic energy in the organism causes biological and physiological reactions. Since the organism is a conductor of the second level, it consists of a large amount of water with an infinite amount of ions dissolved in it. The application of electromagnetic energy to the organism means the acceleration of metabolic responses at various levels, which are used for therapeutic purposes. TECAR evolution generates energy from 0.8-1.2 MHz that was used for the treatment. Nevertheless, the mechanism of action includes the use of high-frequency electricity of heat gain in the body tissues, as a result of the resistance those tissues offer to the current flowing. The patients were lying in the lithotomy position with the streched lower extremities. Probes are placed on the lower part of the abdomen in the area of the bladder (active probe) and on the lumbar spine (passive probe) Figure 1. A capacitive probe in the "free treatment" / "power control" program was used, where high frequency electricity was released to the bladder for 20 minutes with a frequency of 1.0 MHz and energy to maximum 410 C. Initialy, maximum energy of 75% and a frequency of 0.8 MHz was applied, which was reduced depending on the heat that was pleasant for the patient. Then, the power was reduced to 50% and increased the frequency to 1.0 MHz, which also meant moderate energy absorption. The procedure with this energy was continued until the end, and the patients absorbed 18-19 kJ of energy in avarage. Such energy desensitizes the bladder and therefore increases its capacity, increases blood flow and reduces the formation of free radicals , which all together improves the symptoms of OAB and UUI.