Pelvic Floor Stimulation

Gently treating urinary incontinence

Over 13 million men and women in America suffer from incontinence2. Most doctors prescribe pelvic muscle exercises, e.g. Kegel, to increase bladder control. However, many patients can not or will not perform the exercises correctly on their own.

Pelvic floor stimulation and electromyography can be used to teach patients how to perform pelvic floor exercises correctly.

Mechanism of Pelvic Floor Stimulation

Pelvic Floor Stimulation (PFS) applies a mild electrical stimulus to the muscles that support the bladder. The PFS function automates the Kegel exercises for patients unable to contract their pelvic floor muscles.

PFS at a high frequency (50 Hz) causes the pelvic floor muscles to contract through the pudendal nerve reflex loop. Stimulation at a lower frequency (12.5 Hz) can activate a pudendal to pelvic nerve reflex that depresses or eliminates uninhibited bladder contractions.

Electromyography (EMG) measures muscle activity and can be used to assess the patient’s ability to contract his or her pelvic floor muscles. It provides visual and audible information as it teaches the patient to perform pelvic floor exercises correctly.

Advantages of Pelvic Floor Stimulation

  • Low risk treatment that enhances the body’s natural continence mechanism
  • Can be used comfortably and conveniently at home
  • Non-surgical and drug-free treatment option

 

Clinical Application

Electromyography for biofeedback, and Pelvic Floor Stimulation are prescribed by physicians for the assessment and treatment of stress, urge, and mixed incontinence. The Agency for Health Care Policy and Research (AHCPR) has stated that the effectiveness of EGM and PFS as treatment options is supported by solid clinical evidence2.

The Centers for Medicare and Medicaid Services (CMS) implemented a national coverage decision for home-based PFS and in-clinic biofeedback therapy. These modalities are worthwhile inclusions in a cost-effective incontinence treatment program.

The recommended treatment for PFS is twice a day for 15 minutes, every day or ever other day. The program should last for approximately 20 weeks or until the patient is cured or has experienced significant improvement.

1 Urinary Incontinence Guideline Panel. Managing Acute and Chronic Urinary Incontinence: Clinical Practice Guideline Update. AHCPR. 1996;96-0686.

2 AHCRP. Clinical Practice Guideline update. Fri Jul 20 22:34:00 EDT 2007. Urinary Incontenence in Adults;.