Feasibility of Multimodal Energy-Based Therapy for Pelvic Floor Disorders

Background and Objectives: Pelvic floor disorders are highly prevalent among women globally and can severely compromise daily functioning and well-being. Emerging energy-based modalities have reshaped conservative management strategies, by allowing individualized therapeutic approaches. The aim of this study was to evaluate the utility of customized energy-based applications, via an innovative multimodal EVA/DAFNE device that incorporates multimodal energy-based synergistic technologies for the treatment of pelvic floor dysfunction. Materials and Methods: Patients with PFDs (pelvic organ prolapse, all types of urinary incontinence, bladder voiding dysfunction, and dyspareunia) who selected conservative treatments were prospectively enrolled. Baseline and after-treatment quality of life was assessed using the following validated tools: Urinary Distress Inventory-6 (UDI-6), Pelvic Organ Prolapse Distress Inventory-6 (POPDI-6), Female Sexual Function Index-6 (FSFI-6), Marinoff Scale, 0-100 VAS, and Vaginal Health Index. Overall improvement was measured through the Patient Global Impression of Improvement (PGI-I). Three to five sessions of treatment tailored according to the patient's symptoms and clinical findings were delivered. Data were analyzed using standard statistical methods. Results: Twenty-six women with PFD who desired energy-based conservative treatment were recruited. Mean age was 48.6 ± 16.7 years. Indications for treatment were dyspareunia (n = 10; 38.5%), stress urinary incontinence (n = 9; 34.6%), mild pelvic organ prolapse (n = 6; 23.1%), genitourinary syndrome of menopause (n = 5; 19.2%), voiding dysfunction (n = 4; 15.4%), and overactive bladder syndrome (n = 2; 7.7%). Mean number of treatments was four. Baseline and after-treatment quality-of-life scores differed significantly. According to PGI-I scores 88.5% of patients considered themselves improved. Conclusions: Our study provides pilot estimates as to the safety and efficacy of a multimodal integrated treatment protocol for the treatment of PFD. Integrating multimodal energy-based conservative therapy into tailored treatment protocols can prove efficient and useful.