In a retrospective study, Appell and associates (2007) evaluated long-term safety and effectiveness of RF collagen denaturation for SUI in 21 patients from a 12-month, randomized controlled trial utilizing 3-day diaries and the I-QOL survey. Significant increases in overall I-QOL scores 3 years or more post-treatment was the primary end point. Secondary end points were reductions in frequency and severity of incontinence episodes. After 3 years, mean overall I-QOL score improvement was 12.7 (+/- 26); 56 % of patients achieved 50 % or more reduction in frequency. No new AEs occurred. These results indicated that RF collagen denaturation is safe and provides durable effectiveness. This was a longer follow-up (3 years) study of the previous studies reported (Lenihan, 2005; Appell et al, 2006). The authors also noted that additional studies of RF collagen denaturation are ongoing, including a study to expand the indication of RF collagen denaturation in patients who experienced suboptimal responses to a surgical intervention.