Clinical utility of radiofrequency energy for female genitourinary dysfunction: past, present, and future

Stachowicz, Anne M; Hoover, Mallorie L.; Karram, Mickey M.

doi:10.1007/s00192-021-04735-9

Cited by 8 publications

(7 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moreover, the recognized tightening outcome of RF energy recovers the muscle length/tension connection, permitting increased contractile efficacy as defined in the Frank-Starling relationship. Improvements in stress incontinence, atrophic vaginitis, and orgasmic dysfunction, especially after initial RF treatment, with some further improvement observed after the second and third treatments, were noted by Stachowicz et al (2021) .…”

Section: Discussionmentioning

confidence: 91%

Effect of monopolar capacitive resistive radiofrequency in treating stress urinary incontinence: A pilot randomized control trial

et al. 2023

View full text Add to dashboard Cite

ObjectiveTo assess the effectiveness of 448 kHz monopolar capacitive resistive radiofrequency (MCRR) in the treatment of females with stress urinary incontinence (SUI).Materials and methodsForty females with SUI complaints were separated randomly into two equal groups. Group A with 20 females received the MCRR therapy for 20 min and performed pelvic floor exercises for 20 min. Group B with 20 females received placebo treatment by applying the same application as in Group A without emitting any waves for 20 min, three times a week, for 4 weeks. The patients in both groups were instructed to pause the treatment during their menstruation; the patients were instructed to maintain home pelvic floor exercises. Both groups were assessed by a perineometer that was used to assess the strength of the pelvic floor muscles (PFM), the visual analogue scale (VAS), and the Incontinence Symptom Severity Index to assess the frequency of urinary incontinence symptoms as described by each patient before treatment and after 4 weeks of treatment.ResultsThere was a significant reduction (p < 0.05) in VAS and the Incontinence Symptom Severity Index and a significant increase in the strength of the PFM in both groups post-treatment compared with the pre-treatment. Regarding between-subject effects, there was a significant difference in VAS, the Incontinence Symptom Severity Index, and the perineometer between both groups (p < 0.05), and this significant improvement favored Group A.ConclusionMCRR and pelvic floor exercises are more effective methods for the treatment of SUI than just pelvic floor exercises of females with SUI.Clinical Trial RegistrationClinicalTrials.gov. Identifier: NCT04612205.

show abstract

Section: Discussionmentioning

confidence: 91%

Effect of monopolar capacitive resistive radiofrequency in treating stress urinary incontinence: A pilot randomized control trial

et al. 2023

View full text Add to dashboard Cite

show abstract

“…At approximately 50°C, protein coagulation and cell death occur; between 60 and 95°C, desiccation and protein coagulation begin; and at 100°C, vaporization occurs, leading to mass expansion and explosion of the cell. 22 In terms of safety, a lower ablation temperature, such as our 45°C is preferable, although relatively high ablation temperatures like >90°C have been demonstrated to efficiently to treat OAB with some scarring and collateral damage. 15,23 The limitations of this study include using a relatively small sample size of only 14 sheep who were not diagnosed with OAB.…”

Section: Discussionmentioning

confidence: 99%

Detrusor nerve radiofrequency ablation (DENERA): Experimental study of safety and efficacy in an ovine model

Ghoniem,

Mao,

Csuka

et al. 2023

Neurourology and Urodynamics

View full text Add to dashboard Cite

PurposeThe subtrigonal perivesical nerve plexus contains a large proportion of the bladder's innervation. A transurethral radiofrequency ablation approach has successfully denervated this region to alleviate overactive bladder symptoms, with some urothelial heat injury. We report a novel transvaginal RFA device (DENERA) and assess its feasibility and efficacy in denervating the perivesical nerve plexus of in vivo sheep.MethodsIn 14 adult female in vivo sheep, pulsed radiofrequency energy was applied transvaginally for three cycles of 4 min, maintaining the tissue temperature at 45°C, with 30 s of rest between each cycle. The control group (n = 4) was sacrificed without ablation, and various groups were sacrificed 1 week (n = 3), 4 weeks (n = 4), and 12 weeks (n = 3) after ablation. The bladder subtrigones were harvested then analyzed with H&E, S100, and TH immunostaining to quantify their neural density and neural vacuolization.ResultsThe ablation procedure increased the neural vacuolization the most at 1 week and decreased the neural density the most at 4 weeks, with both variables displaying a significant change followed by a slight rebound towards baseline at 12 weeks. The H&E analysis showed that the needles penetrated deep into the subtrigonal detrusor muscle. The sheep recovered from the procedure with no complications or damage in the bladder wall or urothelium.ConclusionsThis study shows that one DENERA treatment can cause subtrigonal denervation with some rebound afterwards and no complications. DENERA may become a promising OAB treatment option that can ablate the perivesical plexus without harming the urothelium.

show abstract

“…These techniques promote improvements in the GSM [7][8][9]. However, although there is some information in the literature regarding the histological effects of CO 2 L in the vaginal mucosa, there are no reports regarding RF or any information concerning the effects of energies in the vulvar vestibule, which is associated with relevant signs and symptoms of GSM [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Fractional CO2 Laser, Radiofrequency and Topical Estrogen for Treating Genitourinary Syndrome of Menopause: A Pilot Study Evaluating the Vulvar Vestibule

Campos,

Bianchi-Ferraro,

de Oliveira

et al. 2023

Medicina

View full text Add to dashboard Cite

Background and Objectives: Genitourinary syndrome of menopause (GSM) affects more than half of postmenopausal women. This study aimed to evaluate the clinical and histological aspects of microablative fractionated CO2 laser (CO2L), microablative fractionated radiofrequency (RF) and intravaginal estrogen (ET) therapy as GSM treatments for the vulvar vestibule. Materials and Methods: This study included postmenopausal women with at least one moderate-to-severe complaint of GSM. Women in the CO2L and RF groups received three monthly sessions of outpatient vulvovaginal therapy. The procedures were performed 30 min after applying 4% lidocaine gel to the vulva and vaginal introitus. Vulvar vestibular pain was assessed after each application using a 10-point VAS. A follow-up evaluation was performed 120 days after beginning each treatment. Digital images of the vulva were obtained and a 5-point Likert scale (1 = much worse, 2 = worse, 3 = neutral, 4 = better, 5 = much better) was used to assess the global post-treatment women’s impression of improvement regarding GSM. Results: A significant change in clinical aspects of the vulva was observed after all treatments with a reduction in the atrophic global vulvar aspect and an enhancement of the trophic aspect. High satisfaction was also reported after treatment according to the Likert scale evaluation: CO2L (4.55 ± 0.97), RF (4.54 ± 0.95), CT (4 ± 1.41), p = 0.066. Histological evaluation revealed enhanced dermal papillae before pre-treatment, significantly reducing post-treatment in all groups (p = 0.002). No unintended effects were reported. Conclusions: CO2L, RF, and ET significantly improved GSM concerning the vulvar vestibule at the 4 months follow-up.

show abstract

Clinical utility of radiofrequency energy for female genitourinary dysfunction: past, present, and future

Cited by 8 publications

References 28 publications

Effect of monopolar capacitive resistive radiofrequency in treating stress urinary incontinence: A pilot randomized control trial

Effect of monopolar capacitive resistive radiofrequency in treating stress urinary incontinence: A pilot randomized control trial

Detrusor nerve radiofrequency ablation (DENERA): Experimental study of safety and efficacy in an ovine model

Fractional CO2 Laser, Radiofrequency and Topical Estrogen for Treating Genitourinary Syndrome of Menopause: A Pilot Study Evaluating the Vulvar Vestibule

Contact Info

Product

Resources

About