Authors (including presenting author) :
Siu YS (1), Tsoi YK (1), Lui BKP (1), Kwok WH (1), Wong TT (1), Lam SS (1), Chan LY (1), Chan LW (1), Tong PY (1), Lee KN (1), Chan TS (1), Ho SKS (1), Pang HSI (1), Lam CY (1), Woo WSS (1), Kng PLC (1)
Affiliation :
(1) Division of Geriatrics, Department of Medicine and Geriatrics, Ruttonjee and Tang Shiu Kin Hospitals
Introduction :
Urinary incontinence (UI) is a distressing and embarrassing common condition that directly affect the quality of life of elderly. Pelvic floor exercise (PFE) training is a proven initial treatment for UI. However, as reported by most clients, barriers like poor muscle isolation technique and low motivation hindered the treatment effect. For these clients, High-Intensity Focused Electromagnetic Field (HIFEM) treatment, which was reported as safe, non-invasive, and effective treatment modality, may act as a supplemental therapy.
Objectives :
1. To augment treatment outcome by helping clients to identify and strengthen pelvic floor muscle. 2. To improve quality of life of clients by reducing urinary leakage and impact of urinary incontinence.
Methodology :
Clients with UI agreed for HIFEM treatment were assessed by Continence team before recruited. Those having contraindications to HIFEM were excluded. Total 6 sessions of 28-minute programmed HIFEM were delivered over 3 weeks at twice per week, during which clients sat on a therapeutic chair in Geriatric Day Hospital. Continence Nurse utilised International Consultation on Incontinence Modular Questionnaire- Urinary Incontinence (Short Form) (ICIQ-SF), Overactive Bladder Symptom Score (OABSS), and number of pads used to understand severity and impact of UI before treatment, at 1-month and 3-month after treatment.
Result & Outcome :
41 clients (40 females, 1 male) of mean age 76 (range from 41 to 94) were recruited across a 15-month period from 6/2022 to 8/2023 and completed all treatments and assessments. On average at 1-month after treatment, ICIQ-SF scoring reduced from 12.1 to 8.3 (t=8.1, p<0.01), OABSS from 7.8 to 6 (t= 4.6, p<0.01), leak frequency from 1.9 to 0.9 times per day (t=4.3, p<0.01), impact rating from 6 to 4.3 on a scale of 10 (t=5.1, p<0.01), nocturia from 3.2 to 2.3 times (t=4.1, p<0.01) and pad use from 1.9 to 1.5 pieces (p=0.13). At 3-month interval, ICIQ-SF scored 8.7 (t=6.2, p<0.01), OABSS at 6.4 (t=2.9, p<0.01), leak frequency decreased to 0.8 times per day (t=3.1, p<0.01), impact rating decreased to 4.2 (t=4.9, p<0.01), nocturia remained the same (t=3.6, p<0.01) and pad use reduced 15% (p=0.29). 40 and 35 clients expressed overall improvement at 1-month and 3-month interval respectively. 5 clients turned leak-free. Most clients reported fading out of HIFEM effect along with time. One-third of clients requested to repeat HIFEM treatment. To conclude, HIFEM treatment was shown to successfully reduce urinary leakage and impact of UI. Further clinical study to understand long-term treatment outcome and effectiveness of combining HIFEM with PFE training is suggested in the long run.
