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The following is a summary of “Intravaginal electrical stimulation of the pelvic floor for women with urinary incontinence – a systematic review of randomised controlled trials,” published in the March 2025 issue of American Journal of Obstetrics & Gynecology by Naidu et al. 

Urinary incontinence (UI), a common and debilitating condition in women, lacks sufficient non-surgical treatment options.  

Researchers conducted a retrospective study to evaluate the effectiveness of intravaginal electrical stimulation in enhancing outcomes and QoL.  

They searched PubMed, EMBASE, Ovid Medline, and IEEE Xplore until February 2025. Randomized controlled trials (RCTs) evaluating intravaginal electrical stimulation against conservative (non-pharmacological and non-surgical) or no treatment/placebo comparators for UI were included. Titles and abstracts underwent independent double screening, and full texts of eligible studies were assessed by at least 2 authors. Bias evaluation was conducted using the Cochrane Risk of Bias Tool 2.0, with disagreements resolved by consensus. Due to trial quality limitations and heterogeneity, meta-analysis was not feasible, and findings were summarized narratively in tabular format.  

The results showed that among 187 studies, 32 RCTs (17.1%) met inclusion criteria. Of the trials reporting specific outcomes, 6 out of 8 (75%) showed significant within-group reductions in pad use for intravaginal electrical stimulation, 10 out of 15 (66.7%) reported reductions in pad weight, and 8 out of 14 (57.1%) demonstrated decreased leakage frequencies with differences compared to passive treatment groups. Findings from bladder diary measurements varied. Increased pelvic floor muscle (PFM) contraction strength, higher maximum cystometric capacity, reduced detrusor overactivity, and improved QoL were noted, though evidence quality was low. Intravaginal electrical stimulation in RCTs had moderate-to-high adherence rates and low risk and severity of adverse events.  

Investigators concluded that intravaginal electrical stimulation shows potential for UI.

Source: ajog.org/article/S0002-9378(25)00163-2/abstract