Conservative treatment of female stress urinary incontinence with functional electrical stimulation

Abstract

Background: Treatment of stress urinary incontinence with functional electrical stimulation (FES) is a recent and efficient method of conservative treatment. Study design: Before treatment, examinations determining the type of urinary incontinence should be made: patient history, pelvic and urologic examination, laboratory tests of urine, multi-channel urodynamic tests. The degree of urinary incontinence is assessed by pad tests. Only the patients with moderate stress urinary incontinence without or with a mild utero-vaginal prolapse, are treated by FES. The parameters of stimulation: the impulse is rectangular and biphasic, duration of impulse is 1 ms, frequency of impulse is 20 Hz, and intensity of current 35 mA. The chronic treatment with FES should be applied 1.5–2 h daily for 3 months. This long-term treatment requires appropriate motivation of the patient. Results: Three months after terminated treatment 56 of the total 111 patients (50.5%) were cured, in 26 (23.4%) the condition improved, whereas in 29 patients (26.1%) the treatment failed. Conclusions: The efficiency of treatment depends on the patient selection, parameters of electrical stimulation, stimulator of the pelvic floor muscles, mode of stimulation—chronic stimulation, and on motivation of the patient.