Electrical stimulation has been proved to be an effective treatment option in managing SUI in many studies. Although the mechanism of electrical stimulation in SUI is unclear, it has been suggested to facilitate pelvic floor muscle contraction by stimulating the efferent motor fibers of the pudendal nerve. This is assumed to induce pelvic floor muscle hypertrophy leading to the strengthening of the muscle contraction and increase urethral pressure. The electrical stimulation may also promote bladder relaxation by inhibiting the parasympathetic vesical motor neuron, which is assumed to be caused by the stimulation on the afferent fibers of the pudendal nerve. The present study aims to evaluate the effectiveness of the Transperineal Pelvic Floor Electrical Stimulation (TPFES) system as a treatment option for females with stress urinary incontinence (SUI).

A total of 34 females who were diagnosed with SUI according to the urodynamic study were included in the study. Twelve and twenty-two patients were assigned to group 1 (sham model ) and group 2 (TPFES), respectively, and the patients were educated to use TPFES or the sham model daily for 12 weeks. The patients were asked to visit the institute at 4, 8, and 12 weeks from the initiation of the study and to complete ‘International Consultation on Incontinence Questionnaire – Urinary Incontinence (ICIQ-UI)’ and ‘Overactive Bladder Symptom Score Questionnaire (OABSS)’. Maximum flow rate (Qmax) and postvoid residual (PVR) were also obtained at every visit. To evaluate the effectiveness of TPFES, repeated-measures ANOVA was performed using the obtained data.

According to the mean ICIQ-UI total score, a significant improvement of SUI was observed in group 2 compared to group 1 (p = 0.023). Also, the mean total scores of ICIQ-UI and OABSS showed significant improvement depending on the duration of TPFES treatment (p <0.001 and p = 0.049, respectively); the scores tended to decrease with the increase of treatment duration (Table 1). The post-hoc test revealed a significant decrease of mean ICIQ-UI total score at 4, 8 and 12 weeks compared to the baseline (p = 0.016, p = 0.015, and p <0.001, respectively). Also, the mean ICIQ-UI total score was significantly affected by the treatment duration of TPFES (p = 0.001; Table 2).

The 4 weeks of elec TPFES treatment improved SUI significantly, and further improvement was presented after continuing the treatment for 12 weeks. Such results imply that a consistent and long-term treatment with TPFES can be an effective treatment option for SUI.

The consistent and long-term use of the TPFES system can be a non-surgical treatment option that effectively improves SUI.