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Published in: International Urogynecology Journal 6/2023

21-01-2023 | Stress Incontinence | Review Article

Sexual function after energy-based treatments of women with urinary incontinence. A systematic review and meta-analysis

Authors: Nádia Pavarini, Ana L. R. Valadares, Glaucia M. Varella, Luiz G. O. Brito, Cássia R. T. Juliato, Lúcia Costa-Paiva

Published in: International Urogynecology Journal | Issue 6/2023

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Abstract

Introduction and hypothesis

Urinary incontinence (UI) affects approximately 50% of adult women worldwide and is associated with declining sexual function (SF). Energy-based devices emerged as a minimally invasive alternative treatment. Nevertheless, their effect on sexuality is uncertain. We hypothesize that the UI energy treatment can lead to sexual function improvement.

Methods

A search was performed in PubMed, Cochrane Library, Web of Science, Embase, and Scopus for randomized clinical trials (RCTs) and nonrandomized studies of intervention, which treated incontinent women using energy, with UI and sexual function (SF) as outcomes. Severe comorbidities, pelvic organ prolapse (POP)> grade 2, and use of medication to treat UI or that affects SF were excluded. Quality assessment and meta-analysis were performed.

Results

From 322 articles, 11 RCTs were included for qualitative analysis. UI symptoms improved in all studies. Regarding SF, RCT with premenopausal women showed improvement in SF in the Er:Yag group (Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 and Female Sexual Function Index). A prospective study showed improvement in SF independent of the grade of SUI. RF showed benefits for SF but was not superior to pelvic floor muscle training. One nonrandomized study of intervention with a High-Intensity Focused Electromagnetic Field showed significant improvement of SF in the Golombok Rust Inventory of Sexual Satisfaction total score, a decline in pain and dissatisfaction domains. Meta-analysis with 4 RCTs and 2 nonrandomized studies found no difference between groups (0.26 (95% CI −0.67 to 1.20, and −0.74 (95% CI −3.78 to 2.30) respectively).

Conclusions

This meta-analysis did not confirm that energy equipment improved the SF of women with UI.
Appendix
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Metadata
Title
Sexual function after energy-based treatments of women with urinary incontinence. A systematic review and meta-analysis
Authors
Nádia Pavarini
Ana L. R. Valadares
Glaucia M. Varella
Luiz G. O. Brito
Cássia R. T. Juliato
Lúcia Costa-Paiva
Publication date
21-01-2023
Publisher
Springer International Publishing
Published in
International Urogynecology Journal / Issue 6/2023
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-022-05419-8

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