“Microablative Radiofrequency for Overactive Bladder: No Significant Difference Compared to Sham in a Randomized Trial”: Most Innovative Abstract at the 2025 Annual IUGA Meeting

Advancement in new technology for the field of urogynecology is now underway, but critically evaluating its role in patient care needs to be prioritized. This is why Dr. Juliato and her colleagues from Univeristy of Campinas in Brazil were awarded the Most Innovative Abstract for their “Microablative Radiofrequency for Overactive Bladder: No significant Difference Compared to Sham in a Randomized Trial” this year at the IUGA/EGUA conference in Barcelona, Spain. Data on the impact of vaginal radiofrequency show promise but are overall mixed when it comes to treating overactive bladder symptoms.

To address this question, Dr. Juliato conducted a multi-centered, patient-blinded, randomized control trial. Women were randomized either to monthly session of vaginal fractional microablative radiofrequency treatments or to monthly sham sessions while undergoing concomitant behavioral therapy as standard of care. Subjective OAB and sexual function outcomes were measured with validated questionnaires (ICIS-OAB, FSFI). Both groups showed improvement in their OAB symptoms as well as sexual dysfunction, no statistically significant difference between the two groups.

The innovation of this study lies in its clinical design to rigorously evaluate an under-studied technology using a robust, blinded control. The sham design included auditory signals to mimic active treatment in an attempt to minimize bias, a frequent challenge in device-based interventional studies. Additionally, including behavioral therapy allowed investigators to impact the true driver of symptomatic response.

This work is particularly timely as vaginal energy devices continue to be promoted for a wide range of pelvic floor symptoms with limited regulatory oversight and insufficient long-term data. The findings remind clinicians and researchers alike that innovation must be measured not only by novelty, but by evidence of meaningful clinical benefit. Here, innovation is demonstrated through transparency, methodological rigor, and a willingness to challenge assumptions.

Congratulations to Dr. Juliato and her colleagues for this innovative work.

Sarah Rozycki, MD

Houston Methodist Hospital

Division of Urogynecology

Houston, TX USA