Transcutaneous electrical neuromuscular stimulation for urinary incontinence

2.1 Stress urinary incontinence is the involuntary leakage of urine during exercise or certain movements such as coughing, sneezing and laughing. Urge urinary incontinence is involuntary urine leakage with a feeling of urgency (a sudden need to urinate that is difficult to delay) during or just before the leakage. Mixed urinary incontinence is involuntary urine leakage associated with both urgency and exercise, effort, sneezing or coughing.

2.2 NICE's guideline on urinary incontinence and pelvic organ prolapse in women has recommendations for the management of urinary incontinence in women, with a patient decision aid to promote shared decision making. NICE's guideline on lower urinary tract symptoms in men has recommendations for the management of urinary incontinence in men. Conventional treatment is conservative and includes lifestyle changes such as weight loss and pelvic floor muscle training. Surgical options are only offered if conservative measures and drug treatments do not help.

2.3 The procedure uses non-implanted electrodes connected to an external neuromuscular electrical stimulator device to stimulate muscles and nerves, to make the pelvic floor muscles contract. The electrical stimulation is delivered through the skin, typically with sticky pad electrodes. The number and placement of electrodes varies according to the system being used. This includes a design in which the electrodes are incorporated into a body garment worn like a pair of shorts. A controller is used to vary the intensity and frequency of stimulations, to achieve a lifting sensation throughout the pelvic floor.

2.4 The device is typically used in sessions. The number and frequency of advised sessions varies, but the treatment period is typically 6 to 12 weeks.

2.5 The aim of the procedure is to reduce symptoms associated with stress or urge urinary incontinence.