Medically Reviewed by Taylor Holmes, PT, DPT, STAR-C

More and more women are talking with their doctor about urinary leakage or incontinence. And that’s a good thing. There’s no reason to live with the embarrassment and anxiety of stress incontinence or an overactive bladder. “Many women may experience relief of symptoms with surgical intervention, medication, or conservative treatment such as physical therapy,” says McLeod Physical Therapist Taylor Holmes. “Physical therapy for urinary incontinence involves pelvic floor muscle training, bladder training, and electrical stimulation. It should be considered a first line of treatment for this condition due to its effectiveness and low risk for adverse effects.”

ELECTRICAL STIMULATION

Women who are unable to contract their pelvic muscles and cannot tolerate or don’t benefit from medication may be helped by electrical stimulation of nerves that control the bladder. Some women say they feel a “tightening” or “lifting” of the pelvic floor from the pulse. But it should not be painful.

On the Skin. A physical therapist can perform electrical stimulation by inserting a small tampon-sized device in the vagina or placing electrodes on the skin near the vagina, anus, or sacrum. These treatments last 12-20 minutes and are typically performed once or twice a week for 8-12 weeks in combination with pelvic floor muscle strengthening and bladder training. Pulses can be used to contract the pelvic floor muscles to help treat stress incontinence or stimulate the nerves that affect the bladder to help control urge incontinence. If this proves to be an effective treatment, patients may purchase a home unit to continue treatments long term.

Under the Skin. Percutaneous Tibial Nerve Stimulation (PTNS) involves the insertion of a very small needle into the lower leg near the tibial nerve. This type of stimulation is used to treat urge incontinence and is performed by a physician. These treatments generally occur in a series of 30-minute treatments over 12 weeks. Typically, the device contracts the muscles for up to 30-seconds, then relaxes for up to another 30 seconds.

Another technique uses a wire implanted under the skin in the lower back and attached to a battery-powered device worn throughout the day.

Sub-percutaneous (Medical speak for “under the skin”), also called Sacral Nerve Stimulation, is not a cure but can reduce symptoms in a majority of women.

Batteries need changing every few years and the device may require occasional adjustment by your physicians.

With Magnets. There is a magnetic stimulation treatment that is sometimes used. The patient sits on a chair (usually in a doctor’s office). Coils in the chair create magnetic waves that tense and relax bladder muscles. However, research on the results of improving symptoms and continence is limited.

OVERALL RESULTS

Some 20% of women were able to control their incontinence symptoms using a form of electrical stimulation with few, if any, side effects.

To determine the cause and type of your incontinence and to review possible treatments, talk with your doctor.

Find a Gynecologist near you.

Sources include: McLeod Health, American Urogynecologic Society Foundation, International Electrical Stimulation Society, National Health Service (UK), National Association for Continence, Agency for Healthcare Research & Quality