Electrical Stimulation for Urinary Incontinence
Electrical stimulation is used to treat urinary incontinence by sending a mild electric current to nerves in the lower back or the pelvic muscles that are involved in urination.
Electrical stimulation is usually done by a physiotherapist or doctor, but you may be able to provide electrical stimulation therapy at home using a unit with a vaginal or anal electrode. Timing and duration of therapy varies. For example, your treatment may consist of 12 weeks during which you have 15-minute stimulation sessions twice a day. This kind of stimulation has been used for both urge and stress incontinence. If you have a home treatment unit, be certain to follow the instructions of your physiotherapist or doctor.
How vaginal or anal electrical stimulation works is not well understood. The stimulation may make the muscles contract, producing an effect similar to Kegel exercises, which strengthen the muscles by contracting them frequently. The stimulation may also encourage the growth of nerve cells that cause the muscles to contract.
Electrical stimulation of the bladder can also be done by placing electrodes under your skin, either through your leg or into your lower back. This is usually done for severe urge incontinence or overactive bladder that hasn't been helped by other treatment.
Posterior tibial nerve stimulation (PTNS) is done by inserting a very small electrode through the skin of your lower leg. The electrode is connected to an electrical stimulator (pulse generator) outside your body. The stimulator sends pulses to the electrode, which stimulates the tibial nerve in your leg. That electrical current then affects the nerve in your lower back that controls bladder and pelvic floor function.
Sacral nerve stimulation (SNS) is done by putting an electrical stimulator under your skin above your buttocks. This stimulator looks like a pacemaker. It is attached to electrodes that send pulses to a nerve in your lower back (sacrum). The sacral nerve plays a role in bladder storage and emptying. Sacral nerve stimulation to treat urinary incontinence is not commonly done in Canada and is not available in all areas.
Why It Is Done
Electrical stimulation may be used to treat:
How Well It Works
Vaginal or anal electrical stimulation has been tried mostly in women who have urge, stress, and mixed incontinence. There is some research that it can help reduce how often women have incontinence.footnote 1
In men who had been incontinent for a year after prostatectomy, pelvic floor exercises and anal electrical stimulation did not improve incontinence any more than pelvic floor exercises alone after 8 weeks.footnote 2
Posterior tibial nerve stimulation may help about half of the people who get it. In one study, about 5 out of 10 people who had the treatment were better after 12 weeks.footnote 3
Sacral nerve stimulation has been studied for urge urinary incontinence that hasn't gotten better with other treatments. Most of the studies have only included a small number of women. In those studies, about half of women had some improvement in urinary incontinence after treatment.footnote 4
Vaginal or anal electrical stimulation can cause pain, tenderness, and bleeding.
The risks of sacral nerve stimulation include:
- Pain where the device is implanted under your skin.
- Movement of the implanted device from its original spot.
What To Think About
Before trying electrical stimulation for urinary incontinence, talk to your doctor about the following:
- Can my incontinence be treated with behavioural or exercise therapy before trying medicine? Behavioural or exercise therapy, such as bladder training or pelvic floor (Kegel) exercises, is noninvasive, can be done at home, has no side effects, and does not limit future therapy options if it is not successful.
- How much experience does the doctor have in treating incontinence? Some doctors do not realize the impact that urinary incontinence can have on a person's life and may disregard your concerns.
- Could any medicines I am taking for another condition be causing my incontinence? Some medicines (especially diuretics) cause the body to produce greater amounts of urine, which may contribute to incontinence problems. Take them when you will easily be able to get to a washroom.
- Onwude JL (2009). Stress incontinence, search date June 2008. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
- Goode PS, et al. (2011). Behavioral therapy with or without biofeedback and pelvic floor electrical stimulation for persistent postprostatectomy incontinence. JAMA, 305(2): 151–159.
- Peters KM, et al. (2010). Randomized trail of percutaneous tibial nerve stimulation versus s efficacy in the treatment of overactive bladder syndrome: Results from the SUmiT trial. Journal of Urology, 183(4): 1438–1443.
- Groen J, et al. (2011). Sacral neuromodulation as treatment for refractory idiopathic urge urinary incontinence: 5-year results of a longitudinal study in 60 women. Journal of Urology, 186(3): 954–959.
Current as of: August 12, 2016
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