Effectiveness of High-Intensity Focused Electromagnetic (HIFEM) Therapy in Women with Urinary Incontinence.

Abstract

Introduction and hypothesis: Urinary incontinence (UI) affects the quality of life of millions of women. High-intensity focused electromagnetic (HIFEM) therapy is a promising noninvasive treatment, but robust evidence is limited. This study aimed to evaluate the effectiveness of HIFEM therapy in improving UI symptoms, quality of life, and sexual function in Thai women.

Methods: This prospective single-arm interventional study enrolled women aged ≥ 20 years with an International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) score ≥ 6. Women with pelvic organ prolapse stage > 2 or with contraindications to HIFEM therapy were excluded. Participants received six HIFEM sessions over 3 weeks. Outcomes, including the ICIQ-UI SF, Incontinence Impact Questionnaire (IIQ-7), and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-IUGA Revised (PISQ-IR), were assessed at baseline, post-treatment, and 3-month follow-up. Generalised estimating equations, mean/median difference (MD) with 95% confidence intervals (CI), were used for statistical analysis.

Results: Fifty-seven women completed the protocol. UI types were stress UI (43.9%), mixed UI (42.1%), and urgency UI (14.0%). Median ICIQ-UI SF significantly decreased at post-treatment (MD -5.21; 95% CI -6.23 to -4.19) and 3 months (MD -5.04; 95% CI -6.13 to -3.94; p < 0.001). IIQ-7 scores improved similarly. Among sexually active women, improvements were noted in arousal/orgasm, and condition impact subscales of PISQ-IR. No significant changes were found in non-sexually active women.

Conclusions: HIFEM therapy significantly improved UI symptoms, quality of life, and some aspects of sexual function. Larger comparative trials with long-term follow-up are needed before routine clinical use is recommended.