Can a TENS Unit Help With Overactive Bladder and Urge Urinary Incontinence?
Hi friends! If you’ve been diagnosed with overactive bladder (OAB) or urge urinary incontinence (UUI), you may have been given one, or many, treatment options. One of those options may have been electrical stimulation and you may have thought to yourself, “How is electrical stimulation going to help my bladder?”
OAB is a set of urinary symptoms, including: a strong "gotta go” sensation (or urgency) and this can result in unintentional leakage, or urge urinary incontinence. OAB often includes needing to pee multiple times during the night (Buckley, 2010). With urge urinary incontinence—whether it is a small drop or a large amount—leakage is accompanied by this strong sensation of urgency (Drake, 2018).
Electrical stimulation is a treatment modality that applies a small electrical current to tissues. There are various goals depending on the treatment settings. Electrical stimulation is used in a variety of conditions, including muscle injuries and neurological conditions.
When treating pelvic floor and bladder disorders there are two ways that electrical stimulation can be used: electrodes/patches placed on the skin or a special probe inserted vaginally or rectally.
The exact mechanism of how electrical stimulation treats overactive bladder is not clear (Bo, 2015), but there are two treatment methods that can be used. One method stimulates the pelvic floor muscles to contract, called NMES (Bo, 2015; Bristow, 1996). The other method stimulates the nerve roots of the sacrum (S2-4) (Bristow, 1996). This can be done either over the sacrum (lower back) or along the posterior tibial nerve (lower leg) (Bristow, 1996). The sacral nerve roots control the sensation and function of the pelvic floor muscles and the pelvic organs, like the bladder.
Research varies on the impact that electrical stimulation has on OAB and UUI; however, research does show that it is better than no treatment or a placebo treatment (Bo, 2015). High quality research studies are limited on the effectiveness of electrical stimulation for treatment (Bo, 2015). There are little to no side effects with electrical stimulation as long as it is not contraindicated by a pre-existing condition like an active infection or a cardiac pacemaker. This makes it a great, conservative treatment option that typically inexpensive.
Electrical stimulation can be used in combination with other treatments like:
Pelvic floor muscle training (Bo, 2015)
Bladder training (Bo, 2015)
Managing constipation (Bo, 2015)
Staying hydrated (Bo, 2015)
Limiting bladder irritants, like caffeine (Bo, 2015)
Medications (Bo, 2015)
Talk with your providers about what treatment options are best for you. You can ask your provider for a referral to pelvic floor physical therapy, or find one at www.mypfm.com/find-a-pt.
To learn more about your pelvic floor muscles, check out these great resources:
Watch our YouTube playlist on Bladder Concerns and Your Pelvic Floor
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Written by Emily Reul, PT, DPT
Bristow SE, Hasan ST, Neal DE. TENS: A treatment option for bladder dysfunction. Int Urogyn J. 1996;7:185-190.
Bo K, Berghmans B, Morkved S, Van Kampen M. Evidenced-based physical therapy for the pelvic floor bridging science and clinical practice. 2nd edition. 2015.
Buckley BS. et al. (2010). Prevalence of urinary incontinence in men, women, and children-current evidence: findings of the fourth international consultation on incontinence. J Urology. doi:10.1016/j.urology/2009.11.078
Drake MJ. Fundamentals of terminology in lower urinary tract function. Neurourol Urodyn. 2018; 37:S13-9. doi: 10.1002/nau.23768.