Comparison of the Effect of Radiofrequency and Laser Treatment on Mixed Urinary Incontinence and Vulvovaginal Atrophy in Iranian Menopausal Women: A Randomized Controlled Trial

Objectives: Radiofrequency (RF) and laser are minimally invasive methods that are used to treat mixed urinary incontinence (MUI) and vulvovaginal atrophy (VVA). The purpose of this study was to compare the effect of RF and laser on UI and VVA in Iranian menopausal women. Materials and Methods: Two hundred and forty women participated in this randomized clinical trial, including those who referred to Valiasr hospital, Tehran, Iran and underwent MUI and VVA treatments in 2018. Participants were randomly divided into the RF (n = 80), laser (n = 80), and placebo (n = 80) groups. Before and after the intervention, UI was assessed using the International Consultation on Incontinence. Finally, pelvic organ prolapse/urinary incontinence sexual questionnaire, vaginal health index (VHI), and visual analog score were used to determine sexual satisfaction. Results: VVA symptoms decreased in RF and laser groups after the intervention although changes in the RF group were more compared to the laser group (15.813 vs. 10.075, P < 0.001). Contrarily, VHI improved in RF and laser groups after the intervention although changes in the RF group were more remarkable in comparison with the laser group (10.425 vs. 2.231, P < 0.001). Based on the results, MUI symptoms decreased after the intervention in RF and laser groups although changes in the laser group were not significant (P <0.149). Eventually, emotional behaviors in the RF group improved after the intervention (P = 0.04) although changes in the laser group were not significant. Conclusions: In general, a greater reduction was observed in the RF group regarding MUI and VVA symptoms compared to the laser group. In addition, using the RF method for the treatment of the genitourinary syndrome of menopause (GSM)symptoms had significantly greater effects on the improvement of the quality of life and sexual satisfaction of menopausal women compared to laser therapy. Thus, RF seems to be an effective and acceptable non-surgical method for the treatment of UI and VVA.