MP87-20 NEW CONCEPT FOR TREATING URINARY INCONTINENCE AFTER RADICAL PROSTATECTOMY WITH RADIOFREQUENCY: RESULTS OF A PHASE ONE STUDY.
INTRODUCTION AND OBJECTIVES
Radiofrequency (RF) is a type of current that when used with a temperature above 41 °C promotes an increase in the production of collagen. Objectives: To describe safety and evaluate the clinical effect of RF in post-prostatectomy urinary incontinence (IUPPR)
This is a pilot study. We included men up to 65 years old, with clinical complaints of IUPPR, who had an ultrasonographic (US) proven post void residual volume (PVRV) < 50 ml, Pad Test of 1 hour > 1 gram and PSA <0.2 ng/ml. Patients with less than 45 days of surgery, urgency urinary incontinence (UUI), patients with neurological degenerative chronic diseases, implantable cardioverter defibrillator and iatrogenic metals in the pelvic region were excluded. The data collection was initiated through a basic anamnestic questionnaire with sociodemographic and clinical information. To assess the clinical response, a 1-hour Pad Test and self-administered questionnaires were performed before and after treatment: ICIQ-SF and ICIQ-OAB At the end of the study, the Likert scale was used to measure the degree of satisfaction with treatment and the modified EVA for urinary incontinence (UI) to assess the course of symptoms. Safety was verified by reporting or observing adverse effects and PVPR verification by US. Participants underwent five sessions of non-ablative endoanal RF. The temperature used in the treatment was 41°C and once achieved, it was kept for 2 minutes, while the therapist performed half-moon movements slowly
The sample consisted of 10 men with a mean age of 57.5 ± 4.9 years. The initial Pad Test was 6.5g (1.7-50.0) and the final was 2.0g (0.0-9.0) (p <0.01). The US had no change in PVPR. In the Pad Test, 90% presented decrease and 30% complete resolution of the urinary loss. ICIQ-OAB indicated a significant decrease in irritative micturition symptoms. The ICIQ-SF showed no significant difference. Regarding the degree of satisfaction, two patients were unchanged, six satisfied and two very satisfied. In the report of the patients, four had pain during the positioning of the endoanal electrode, ceasing during the application of RF
RF has been shown to be a safe technique for the treatment of IUPPR, with positive results both in improving urinary loss and in reducing irritative micturition symptoms, promoting patient satisfaction. However, to increase the validity of the study, larger clinical trials are warranted