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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.