Electrical Stimulation for Urinary Incontinence

Treatment Overview

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.

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.

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.

Why It Is Done

Electrical stimulation may be used to treat:

• Overactive bladder.
• Stress incontinence.
• Urge incontinence.
• Mixed stress and urge incontinence.

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}

Risks

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.
• Infection.