Nerve stimulation devices

These devices transmit electrical current to specific nerves or muscles with the goal of strengthening pelvic floor muscles or targeting nerves involved in creating urinary urgency. Unlike some types of nerve stimulation, such as sacral nerve stimulation, these therapies do not involve surgery.

Pelvic floor stimulation
If your pelvic floor muscles are extremely weak or if you have trouble telling what it feels like to tense them, electrical pelvic stimulation may be helpful. In this procedure, a weak electrical current is applied through electrodes that are placed either near the muscles or directly into the nerves they're designed to stimulate. The electrical stimulation causes your pelvic floor muscles to contract without effort on your part (passive contractions). If you're able to do Kegel exercises but your pelvic floor muscles remain weak, electrical pelvic stimulation may be used along with strengthening exercises.

Electrical pelvic stimulation can be effective for urge incontinence, but it often takes several months and multiple treatments to work. The procedure may be done in your doctor's or therapist's office, or you can do it at home with a portable battery-operated device.

Tibial nerve stimulation
Inspired by acupuncture, this method of electrical stimulation is used specifically to treat urge incontinence, often by people who have exhausted other conservative methods and would rather not have surgery. The tibial nerve — located in your lower leg — is connected to the sacral nerve group, which plays a direct role in regulating bladder contractions. Stimulation of the tibial nerve can help to moderate the imbalanced nerve messages an overactive bladder sends to the brain, reducing the number of bladder contractions and the symptoms of urgency and frequency.

Tibial nerve stimulation may be done in your doctor's office. During the procedure, a thin needle is inserted just above your anklebone. Low-frequency electrical stimulation is passed through the needle to your tibial nerve for approximately 30 minutes. The procedure is painless, but you might notice your toes spread out or your big toe curl. You may also feel a sensation spread through the sole of your foot. The stimulation is applied once a week for about three months and then as needed thereafter, depending on your response to the therapy.

Catheters

As a last resort, your doctor or nurse practitioner may recommend that you use a urinary catheter. This is an option for those who don't have success with other treatments, who find other treatments unacceptable or who need help while waiting for a treatment such as surgery.

A catheter is a thin tube that's placed in your urethra to allow you to drain your bladder manually. This may be done for you, or you can learn to do it yourself. In some cases, the catheter may be left in. The catheter connects to an external bag that holds urine. You empty the bag as needed.

If you have nerve damage, using a catheter at regular intervals can help empty your bladder completely and prevent overflow incontinence.

Common side effects of using a catheter include urinary tract infections and skin irritation. Careful maintenance of sterile techniques while using the catheter can help you avoid these problems.

Jan. 29, 2011 See more In-depth