Pelvic floor electrical stimulation is a therapeutic procedure used in the treatment of an insufficient (non-functioning) pelvic floor. Electrical stimulation strengthens the muscular floor of the pelvic cavity, which primarily supports the organs of the lesser pelvis. The pelvic floor consists of the pelvic diaphragm (levator ani and coccygeus muscles), and the urogenital diaphragm (perinei superficialis and transversus perinei profundus muscles). The tense pelvic floor muscles are essential for continence in both women and men. It supports the sphincters of the anus and urinary bladder. Weakness of the pelvic floor muscles is a common cause of urinary incontinence (impaired reservoir function of the urinary bladder with involuntary leakage of urine).
Indications (areas of application)
- Stress incontinence (formerly: stress incontinence) – involuntary leakage of urine when intra-abdominal pressure increases (abdominal pressure increases, for example, when coughing, sneezing, and lifting heavy loads)
- Urge incontinence – involuntary leakage of urine during urination.
- Fecal incontinence
- Incontinence after prostate surgery
Contraindications
- Acute vaginal infection (vaginal infections).
- Urinary tract infection (UTI)
- Cardiac pacemaker
- Pregnancy
The procedure
Pelvic floor stimulation involves inserting an electrical pulse generator directly into the vagina (vagina) or anus. It is a small electrode that transmits weak electrical current pulses of about 40-80 mA (milliamperes) to the pelvic floor muscles, triggering contraction. The pulse duration is about 5-10 seconds and is interrupted by a pause (about 20 seconds). The muscles are automatically contracted without the patient’s intervention. Electrostimulation can be performed in three ways:
- Transanal (via the anus)
- Transvaginal (via the vagina)
- Via surface electrodes
The following mechanisms are thought to have an impact on therapeutic success:
- Increase in musculature – especially strengthening of the holding muscles.
- Improving the ability to contract
- Increase muscle tone
- Normalization of the reflex pattern of the sphincters (sphincters).
Electrostimulation of the pelvic floor muscles should be done in combination with physiotherapy pelvic floor training, because the patient often has to learn the conscious tension of these muscles. The devices for pelvic floor stimulation usually also enable biofeedback. This means that the patient receives information about the contraction state of his pelvic floor muscles, which are otherwise difficult to control voluntarily and actively, by means of an acoustic or visual signal via the electrode. In this way, more targeted pelvic floor training can be achieved by directly monitoring success. Electrostimulation should be used daily and regularly, and therapy success can be achieved after three to six months with consistent training. The devices are usually also suitable for home use.
Benefits
Pelvic floor stimulation is a useful addition to physiotherapeutic pelvic floor training and can counteract urinary incontinence in particular.
