Researchers at the Laboratory of Research in Women’s Health, Federal University of Sao Carlos have found that both intravaginal and surface electrical stimulation are effective ways to treat stress urinary incontinence. The study was published in the European Journal of Obstetrics and Gynecology and Reproductive Biology in 2014. Forty-five women candidates over age 50 who had only symptoms of stress urinary incontinence and had not had surgery nor undergone any physical therapy for their incontinence were selected for the study.
Women were separated into three treatment groups, Intravaginal electrical stimulation (IVES), Surface electrical stimulation (SES), and Control. Pre- and post-measurements were taken of women’s pelvic floor muscle (PFM) contraction strength and pad-test weight. Women performed the pad test by first emptying the bladder, consuming 500 mL of water, waiting 30 minutes and then taking part in a set of exercises for 30 minutes, and finally weighing the change in pad-weight. A Quality of Life evaluation was completed to address areas such as general health, impact, and limitations including those related to daily activities, physical, social, personal, emotional, and sleep. IVES and SES were conducted on the separate groups for twelve total treatment sessions per woman, two per week for twenty minutes each. Women were instructed to lay flat with knees bent; IVES was applied using an intravaginal probe while SES was conducted using four gel patches placed on the pubic region and buttocks. Sessions consisted of user-controlled maximum-tolerable stimulation intensity alternating with rest. Statistical calculations were done using the Mann-Whitney test for pairwise comparison with a level of p < 0.05 for statistical significance.
There was a significant reduction in urinary leakage (pad weight) in both the IVES and SES groups, but not the control group. There was also significant improvement in vaginal strength in the IVES but not in the SES or control groups. Quality of life improved in both the SES and IVES groups. Patients felt less restricted in daily activities, had better sleep quality, and emotionally improved. The authors suggest that electrical stimulation not only stimulates the pudendal nerves to contract and strengthen the PFM, but also improves the PFM response and coordination during leakage type of events, as well as increases blood-flow to improve the nerve-muscle connections.
Based on these results, the study presents SES as effective as IVES for treating stress urinary incontinence. However, SES is a desirable alternative due to its comfort, affordability, less-invasive nature, decreased risk of infection, and increased ease of use. In summary, SES is presented by the authors as a viable alternative treatment for stress urinary incontinence as compared to the long-established IVES treatment.
Correia, Pereira, Hirakawa, & Driusso. (2014). Effects of surface and intravaginal electrical stimulation in the treatment of women with stress urinary incontinence: Randomized controlled trial. European Journal of Obstetrics and Gynecology, 173, 113-118.