Evaluating the Efficacy of High-Intensity Focused Electromagnetic (HIFEM) Therapy for Postprostatectomy Incontinence in Men

Halil Tosun,1 Emre Can Akinsal,1 Unsal Bas,2 Gokhan Sonmez,1 Numan Baydilli,1 Deniz Demirci1 1Department of Urology, Erciyes University Faculty of Medicine, Kayseri, Turkey; 2Department of Urology, Dr Ekrem Karakaya Hospital, Kayseri, TurkeyCorrespondence: Emre Can Akinsal, Department of Urology, Erciyes University Faculty of Medicine, Kayseri, Turkey, Tel +90 532 588 16 46, Fax + 90 352 437 52 85, Email [email protected]: Urinary incontinence (UI) is a common complication after radical prostatectomy (RP), adversely affecting patients’ quality of life. This study aimed to evaluate the efficacy and safety of high-intensity focused electromagnetic (HIFEM) therapy as a non-invasive treatment for post-prostatectomy UI.Patients and Methods: Twenty-seven men (mean age ± SD: 67.9 ± 3.4 years) with persistent UI after RP underwent six HIFEM sessions (28 min, twice weekly) using the BTL EMSELLA® chair. Outcomes were assessed after the sixth session and at one-month follow-up. Primary endpoints were changes in International Consultation on Incontinence Questionnaire–Short Form (ICIQ-SF) scores and daily pad use.Results: Baseline mean ICIQ-SF score was 10.58 ± 4.15. This decreased to 5.43 ± 3.85 after treatment and to 4.16 ± 3.97 at one month, representing improvements of 53.1% and 60.6%, respectively (both p < 0.005). Daily pad use declined from baseline to 1.45 ± 1.54 after treatment and 1.13 ± 1.81 at follow-up (both p < 0.001). No adverse events were reported.Conclusion: HIFEM therapy significantly improved UI severity and reduced pad dependence in men with post-prostatectomy incontinence, with effects sustained for at least one month and no observed side effects. These findings support HIFEM as a safe, non-invasive treatment option warranting further study in larger, long-term trials.Keywords: urinary incontinence, HIFEM, pelvic floor muscles