Safety and best practice in neuromuscular electrical stimulation for pelvic floor muscle dysfunction

Author(s): POGP - Pages: 68-76

Abstract

This statement is based on a synthesis of the best available evidence, and the clinical knowledge of experienced healthcare professionals. It will be subject to periodic review as the evidence base evolves. This statement offers guidance, and should not be regarded as prescriptive; such advice will always require to be modified in accordance with the needs of the individual patient, and the clinician’s skills and knowledge. The aim of this statement is to outline best practice and safety considerations for clinician-led neuromuscular electrical stimulation (NMES) for adult male and female pelvic floor muscle (PFM) dysfunction. It includes the use of vaginal and anal electrodes, and also portable, battery-powered NMES devices and mains-powered machines. Indwelling and implanted electrodes, and percutaneous posterior tibial nerve stimulation (PTNS), transcutaneous electrical nerve stimulation (TENS) and magnetic electrical stimulation for pelvic floor dysfunction are not covered in this statement. The document provides short
summaries of the evidence for the use of NMES when the desired physiological outcome is muscle strengthening or neuromodulation in people
with symptoms of stress urinary incontinence (SUI), overactive bladder (OAB) and/or faecal incontinence (FI). Most of the data cited in this statement are derived from clinical trials involving female participants; there have been very few studies of NMES for men. Recommendations on how to achieve optimal results and safe practice are made.