2022 Volume 18 Issue 1 Pages 58-62
Although it has a low consultation rate (9%), urinary incontinence is a common issue in females that can significantly compromise quality of life. There are invasive medical treatments but complications are not uncommon. Therefore, safer and more effective minimally invasive medical treatment strategies are being sought after.
We investigated the efficacy of transvaginal high-intensity focused ultrasound (HIFU) for the treatment of urinary incontinence in patients, inclusive of elderly patients. The study includes 46 cases of transvaginal HIFU, covering a three year period. To evaluate the efficacy of HIFU, we used the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and those results showed significant efficacy up to 2 years post implementation. Maximum squeeze pressure, an indicator of external anal sphincter muscle strength, increased significantly post-implementation. Regarding patients with coexisting fecal incontinence, there was improvement across the board; Wexner score for fecal incontinence was significantly lowered. Our long-term observation therefore suggests that transvaginal HIFU can be useful as a minimally invasive treatment strategy for urinary incontinence with elderly patients. Recent studies report that the right and left bulbocavernosus muscles in women join the anterolateral side of the external anal sphincter, and that the dorsal vaginal wall is actually the external anal sphincter muscle. Considering this newer anatomical understanding, our direct treatment of the external anal sphincter on the dorsal side may have helped increase the external anal sphincter’s squeeze pressure and improved fecal incontinence.
