Efficacy and Safety of HIFU in Improving Bladder Control in Women with Urinary Incontinence

Authors

  • Sampana Fatima Shahida Islam Medical College, Bahawalpur
  • Aqsa Saleem CMH Multan
  • Sana Rauf Sadiq Abbasi Hospital, Bahawalpur
  • Shagufta Awais Aster Sanad Hospital Riyadh, KSA
  • Saadia Kanwal Alnafees Hospital, Islamabad
  • Wajeeha Imam CMH Multan

DOI:

https://doi.org/10.47489/szmc.v39i1.576

Keywords:

Pelvic Floor Training, High-Intensity Focused Ultrasound, Urinary Incontinence

Abstract

Introduction: Urinary incontinence is a common gynecological issue, affecting millions of women worldwide due to the weakening of pelvic floor muscles.

Aims & Objectives: To evaluate the efficacy and safety of High-Intensity Focused Ultrasound (HIFU) for strengthening pelvic floor muscles and improving bladder control in women with urinary incontinence.

Place and Duration of Study: The study was conducted at CMH Multan from April 2023 to May 2024 in collaboration with the gynecology and urology departments.

Material & Methods: The current non-randomized trial included 100 females diagnosed with urinary incontinence and aged ?35 years through non-probability convenience sampling. This study adopted a unique HIFU treatment consisting of weekly 20-minute sessions over 8 consecutive weeks. The primary outcome was a change in urinary incontinence symptoms measured by the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) score. Secondary outcomes included a reduction in incontinence episodes, bladder control parameters (maximum bladder capacity and detrusor pressure), strengthening pelvic floor (perineometry, digital palpation), life quality (I-QOL and PFDI-20), and adverse events. Descriptive statistics were expressed using SPSS version 23.0, as mean ± SD or frequency/percentages to check the mean difference across the two groups, t-test was applied. A p-value of <0.05 was considered statistically significant.

Results: The HIFU group showed a significant decrease in ICIQ-UI SF scores (-6 ± 2) compared to the non-HIFU group (-2 ± 1, p < 0.001). HIFU participants experienced a greater decrease in incontinence episodes (10 ± 3 vs. 4 ± 2, p< 0.001) and improvements in bladder control and muscle strength. Participants undergoing HIFU demonstrated a significant rise in the I-QOL score (p < 0.01), with 80% reporting subjective improvement. The HIFU group also experienced minimal adverse effects and the results were significant. P<0.05.

Conclusion: HIFU is an effective, safe, and non-invasive treatment for urinary incontinence, significantly improving symptoms, bladder control, muscle strength, and life quality while offering minimum to no adverse effects.

References

Tesemma MG, Sori DA, Hajito KW. Prevalence of urinary incontinence and associated factors, its impact on quality of life among pregnant women attending antenatal care at Asella teaching and referral hospital. BMC Urol [Internet]. 2024 Aug 24;24(1):178. Available from: https://bmcurol.biomedcentral.com/articles/10.1186/ s12894-024-01560-2

Lugo T, Leslie SW, Mikes BA, Riggs J. Stress Urinary Incontinence [Internet]. StatPearls. 2025. Available from:

http://www.ncbi.nlm.nih.gov/pubmed/24848922

Turner B, Cranston D. A Review of High-Intensity Focused Ultrasound. Int J Transl Med [Internet]. 2024 Mar 12;4(1):197–207. Available from: https://www.mdpi.com/2673-8937/4/1/11

Oh S, Rhee DY, Batsukh S, Son KH, Byun K. High- Intensity Focused Ultrasound Increases Collagen and Elastin Fiber Synthesis by Modulating Caveolin-1 in Aging Skin. Cells [Internet]. 2023 Sep 14;12(18):2275. Available from: https://www.mdpi.com/2073-4409/12/18/2275

Önder Dirican A, Ceran MU, Kahraman O, Sönmez MG. High-intensity focused ultrasound (HIFU) for the treatment of female urinary incontinence: A retrospective analysis. Medicine (Baltimore) [Internet]. 2024 Oct 4;103(40):e39940. Available from: https://journals.lww.com/10.1097/MD.0000000000 039940

Medicine T. Review of the use of intravaginal hifu therapy for the treatment of vulvovaginal atrophy ,. 2023;4:27–33.

Romeikien? KE, Bartkevi?ien? D. Pelvic-Floor Dysfunction Prevention In Prepartum And Postpartum Periods. Medicina (B Aires) [Internet]. 2021 Apr 16;57(4):387. Available From: Https://Www.Mdpi.Com/1648-9144/57/4/387

Silantyeva E, Zarkovic D, Astafeva E, Soldatskaia R, Orazov M, Belkovskaya M, Et Al. A Comparative Study On The Effects Of High- Intensity Focused Electromagnetic Technology And Electrostimulation For The Treatment Of Pelvic Floor Muscles And Urinary Incontinence In Parous Women: Analysis Of Posttreatment Data. Female Pelvic Med Reconstr Surg [Internet]. 2021 Apr;27(4):269–73. Available From: Https://Journals.Lww.Com/10.1097/SPV.00000000 00000807

Tonguc T, Recker F, Ganslmeier J, Strunk HM, Pieper CC, Ramig O, Et Al. Improvement Of Fibroid-Associated Symptoms And Quality Of Life After US-Guided High-Intensity Focused Ultrasound (HIFU) Of Uterine Fibroids. Sci Rep [Internet]. 2022 Dec 7;12(1):21155. Available From: Https://Www.Nature.Com/Articles/S41598- 022-24994-W

Venegas M, Carrasco B, Casas-Cordero R. Factors Influencing Long-Term Adherence To Pelvic Floor Exercises In Women With Urinary Incontinence. Neurourol Urodyn [Internet]. 2018 Mar 2;37(3):1120–7. Available From: Https://Onlinelibrary.Wiley.Com/Doi/10.1002/Nau. 23432

Downloads

Published

2025-03-24

How to Cite

1.
Sampana Fatima, Aqsa Saleem, Sana Rauf, Shagufta Awais, Saadia Kanwal, Wajeeha Imam. Efficacy and Safety of HIFU in Improving Bladder Control in Women with Urinary Incontinence. Proceedings S.Z.M.C [Internet]. 2025 Mar. 24 [cited 2025 Apr. 2];39(1):06-11. Available from: https://proceedings-szmc.org.pk/index.php/szmc/article/view/576