Transvaginal electrical stimulation in the treatment of genuine stress incontinence and detrusor instability

Electrical stimulation has been widely used in Europe to treat incontinence, but original studies and overall use of the device has been limited in North America. Forty-five patients with documented genuine stress incontinence, detrusor instability or mixed incontinence had self-administered therapy for 15 minutes twice daily, for a duration of 6 weeks. Treatment was delivered by a new stimulation device with an attached vaginal probe. Patients recorded treatment times, leak episodes and pad use. Objective measures included a pad test, standing stress test, standing CMG, and resting and dynamic urethral closure pressure profiles. The subjective success rates based on a questionnaire were 71% for genuine stress incontinence, 70% for detrusor instability, and 52% for combined incontinence. Objective testing for both types of incontinence did not show significant improvement after treatment. Four patients reported pain during use of the device, but most wished to continue the device in preference to other therapy.Supported in part by a grant from Hollister Incorporated.