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HIFEM procedure for Treatment of Persistent Urinary Incontinence Post Pelvic Organ Prolapse and Anti-Incontinence Surgery

Diya Singhal*, Manish Gopal

Introduction and Hypothesis: POP (pelvic organ prolapse) and anti-UI (urinary incontinence) surgery are performed to restore the function of the female pelvic floor. The study aims to determine the effectiveness of the electromagnetic muscle stimulation (HIFEM) procedure as a form of postoperative pelvic floor physiotherapy on women who have undergone POP and anti-UI surgery.

Methods: Fifty females received a total of six HIFEM procedures scheduled twice a week over three weeks with follow-up visits after the last treatment and at 3 and 6 months. BFLUTS-SF questionnaire was used to evaluate UI and quality of life (QOL) before and after treatments.

Results: The mean pre-treatment combined score was 17.4±1.5 points. The score decreased significantly (p<0.001) at 3 and 6 months to 11.9±1.5 (-5.5 points) and 12.6±1.7 (-4.8 points), respectively. The women with three or more childbirths had significantly better improvement in average BFLUTS-SF score (-7.0 points) compared to women with a maximum of two deliveries (-4.4 points) at 3 months, when the results peaked. Overall, the results were not associated with the severity of the prolapse, and the most prominent changes were seen in the Incontinence, Filling, and QoL domains.

Conclusions: The data indicate that the HIFEM procedure significantly reduces the severity of lower urinary tract symptoms including UI while improving the QoL in subjects with persistent post-surgery incontinence.