Microablative Radiofrequency Versus Sham for Overactive Bladder: A Randomized Controlled Trial With 6 Months Follow Up.
Constanza Alvear, Cássia Raquel Teatin Juliato, Anna Lygia B Lunardi et al.
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In 30 seconds
This bicenter, double-blind randomized controlled trial compared microablative radiofrequency (RF) plus behavioral therapy (BT) with sham plus BT in women aged 45–65 years with overactive bladder or urgency-predominant mixed urinary incontinence. Among 140 randomized participants, both groups improved in OAB symptoms, with effects maintained at 6 months; RF was not superior to sham. RF was associated with improvements in several pelvic-floor measures, but adverse events were more frequent than with sham (44.2% vs. 22.9%; p = 0.025).
Key findings
- OAB symptoms improved in both groups, and improvements were maintained at 6 months.
- RF plus BT showed no superiority over sham plus BT for the primary OAB symptom outcome.
- Pelvic-floor tone, palpation pain, and contraction measures improved in the RF group.
- Adverse events were more frequent with RF than sham (44.2% vs. 22.9%; p = 0.025).
Why it matters
The trial helps clarify the added value of microablative RF for women with OAB: symptom improvement also occurred with sham treatment when both groups received behavioral therapy. The higher adverse-event frequency with RF is relevant when weighing this procedure against behavioral management, while the pelvic-floor findings warrant interpretation alongside the absence of demonstrated superiority for OAB symptoms.
What to keep in mind
Follow-up was limited to 6 months, and both groups received behavioral therapy, so the trial does not isolate the effect of behavioral therapy itself.