Introduction and Hypothesis <p>This study was aimed at comparing the efficacy of different modes of transvaginal temperature-controlled radiofrequency (TTCRF) in improving female stress urinary incontinence (SUI).</p> Methods <p>A randomized trial with a nested prospective cohort included 89 women with SUI, who were randomized into a unipolar group (<i>n</i> = 35) and a comprehensive group (<i>n</i> = 54). The comprehensive mode group was treated with unipolar and bipolar combination therapy. The 1-h pad test (1-h PWT) was used as the primary metric by which to gauge improvement of SUI. The effective rate was defined as (cure + improvement cases/total cases) × 100%. Daily leakage episodes and urinary incontinence questionnaires were also documented to compliment this metric in assessing treatment efficacy. Patient satisfaction was assessed and adverse reactions were monitored.</p> Results <p>No significant difference in the effective rate between the unipolar and comprehensive groups was observed at 1, 3, 6, and 12&#xa0;months after the end of treatment (62.9% vs 66.7%, 68.6% vs 68.5%, 80.0% vs 71.7%, 74.3% vs 62.5% respectively). Objective improvement of SUI symptoms and subjective satisfaction for all SUI patients were achieved after TTCRF treatment. Ten-course treatment of TTCRF achieved significantly greater treatment effects than five-course treatment as measured by 1-h PWT, daily leakage episodes, International Consultation on Incontinent Questionnaire-Short Form, and Pelvic Organ Prolapsed-Urinary Incontinence Sexual Questionnaire-12. No significant side effects occurred in any patients during treatment.</p> Conclusions <p>We consider TTCRF treatment to be a viable outpatient option for SUI, with unipolar and comprehensive modes both showing similar efficacy for SUI.</p>