Comparison of the effects of High-Intensity Focused Electro-Magnetic (HIFEM) and Pelvic Floor Muscle Training (PFMT) on Symptom Improvement and Quality of Life in patients with Urinary Incontinence

Abstract

Background: Urinary incontinence (UI) represents a prevalent condition that exerts considerable physical, psychological, and social burdens. Pelvic floor muscle training (PFMT) is the established first-line conservative intervention; however, its efficacy relies heavily on patient compliance and correct technique. Recently, High-Intensity Focused Electromagnetic (HIFEM) stimulation has emerged as a non-invasive alternative capable of eliciting supramaximal pelvic floor contractions. Comparative evidence between HIFEM and PFMT remains limited in Indonesia. Methods: This randomized controlled trial was conducted at the Urology and Medical Rehabilitation Clinics, Dr. Saiful Anwar General Hospital, Malang. Twenty individuals diagnosed with UI were randomly assigned to HIFEM (n = 10) or PFMT (n = 10) groups. Both interventions were administered for 30 minutes per session, twice weekly, over three weeks. Outcomes were measured pre- and post-intervention using the International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form (ICIQ-UI SF) and the King’s Health Questionnaire (KHQ). Within-group comparisons employed paired t-tests, while between-group analyses utilized independent t-tests. Results: Baseline characteristics were similar between groups. The HIFEM group exhibited a significant reduction in ICIQ-UI SF scores (–4.30±3.43, p = 0.003), whereas the PFMT group showed a smaller, non-significant decrease (–0.70±1.06, p = 0.066). Between-group comparisons revealed superior improvement with HIFEM (p = 0.005). Quality of life, assessed via KHQ, improved significantly in the HIFEM group (–6.80±3.25, p = 0.006) but not in the PFMT group (–3.10±3.21, p = 0.057). HIFEM enhanced general health perception, physical, role, social, and emotional domains, as well as severity measures, while PFMT improvements were confined to physical limitations and incontinence impact. Conclusion: HIFEM therapy demonstrated superior short-term efficacy compared with PFMT in reducing urinary incontinence symptoms and enhancing quality of life. These findings support the use of HIFEM as a promising non-invasive treatment modality, particularly for individuals with limited adherence to PFMT. Larger-scale studies with extended follow-up periods are warranted to validate long-term outcomes.