Application progress of radiofrequency (RF) therapy in pelvic floor disorders (PFDs): a narrative review focusing on randomized controlled trials.

Background and Objective: The application of radiofrequency (RF) therapy in pelvic floor disorders (PFDs) has been on the rise. However, its efficacy and safety remain a subject of debate. This narrative review aims to synthesize the current evidence from randomized controlled trials (RCTs) on the application of RF therapy in PFDs, including vaginal laxity syndrome (VLS), stress urinary incontinence (SUI), chronic pelvic pain (CPP), and fecal incontinence (FI). This narrative review was conducted to synthesize the current evidence on the application of RF therapy in PFDs, with a specific focus on RCTs to ensure the robustness and reliability of the included evidence. Methods: We conducted a narrative literature review using PubMed, Embase, and Scopus covering the period from January 2002 to July 2025. RCTs investigating the efficacy, safety, and mechanisms of RF therapy in PFDs were included. Non-randomized studies and reviews were referenced for contextual support but not as primary evidence. Key Content and Findings: RF technology, a non-invasive/minimally invasive energy-based modality, shows potential in managing PFDs. For VLS, limited RCTs confirm its efficacy in improving symptoms and sexual function with good safety, though treatment protocols and efficacy duration need further study. In SUI, RF works as an effective adjunct to pelvic floor muscle training, but its standalone efficacy and comparison with other modalities require more high-quality research. For CPP and FI, RF's efficacy and safety remain controversial, lacking sufficient evidence-based support for widespread use, with relevant guidelines not recommending it currently. Conclusions: Overall, the application of RF therapy in PFDs is still in the exploratory stage, with numerous unresolved issues such as inconsistent treatment parameters, short follow-up periods, small sample sizes, and a predominance of single-center studies. Future research should focus on designing rigorous multi-center, large-sample RCTs, optimizing treatment protocols, clarifying the mechanisms of action, establishing scientific efficacy evaluation systems, and conducting stratified analyses based on individual differences. This will promote the precise, safe, and effective application of RF therapy in PFDs, providing more high-quality treatment options for patients with PFDs.