This original study evaluates the efficacy and safety of transvaginal low-energy micro-needling radiofrequency (RF) ablation as a minimally invasive treatment for overactive bladder (OAB) in an office setting. By targeting specific anatomical regions, this approach aims to provide a novel alternative to conventional therapies while minimizing side effects and improving patient outcomes.

A prospective clinical study was conducted on 32 patients with primary or refractory OAB. Each patient underwent transvaginal RF ablation at depths of 3, 5, and 7 mm in a predefined anatomical region of the anterior vaginal wall. Patients were reassessed for four weeks following treatment. If symptom improvement was less than 50%, additional treatments were performed at four-week intervals, with a maximum of three sessions. If symptom improvement exceeded 50%, patients were followed longitudinally without additional intervention. The primary outcome was the change in urge incontinence episodes as recorded in a three-day voiding diary. Secondary outcomes included changes in frequency episodes, Visual Analog Scale (VAS) pain scores, Incontinence Impact Questionnaire-7 (IIQ-7), Urinary Distress Inventory-6 (UDI-6), Patient’s Perception of Bladder Condition (PPBC), and the Patient Global Impression of Improvement (PGI). An immediate post-procedure pain assessment was also conducted. Patients were followed at one month, three months, six months, and are planned for one-year post-treatment.

All 32 patients were treated and followed for six months. Significant improvement in OAB symptoms was observed across all outcome measures at one-month, three-month, and six-month follow-ups, with statistical significance noted across all metrics (p < 0.01). No patient required a second treatment, indicating a high initial success rate. VAS pain scores demonstrated minimal to no discomfort post-procedure, reinforcing the safety and tolerability of this approach. No adverse effects were reported.

These findings suggest that transvaginal RF ablation is a promising, well-tolerated, and effective treatment for OAB. The procedure provides sustained symptom relief with a single-session approach, demonstrating a favorable safety profile. The absence of significant pain or complications supports its potential as an alternative to pharmacological and surgical interventions. Further long-term data collection is ongoing to assess the durability of these results.

Minimally invasive transvaginal RF ablation offers a viable alternative for patients with OAB, with significant clinical improvement observed over six months. Long-term follow-up will provide further insight into treatment durability and patient outcomes.