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Electrical muscle stimulation for the conservative management of female pelvic floor dysfunction: a systematic scoping review

Sekhon B1, Whitelaw H2, Dufour S2

1. McMaster Univerity, 2. McMaster University

KEYWORDS: Conservative Treatment, Pelvic Floor, Rehabilitation

Female pelvic floor dysfunctions are common. Given the differing phenotypic presentations across females with these dysfunctions, effective conservative, pharmacological and surgical care options are all important. Although individualized and supervised pelvic floor muscle training is currently established as the most effective conservative care strategy (1), adjunctive therapies are often used to further augment outcomes or better align with patient preferences for care. Electrical muscle stimulation (EMS) represents a long standing established conservative management strategy currently recommended to be used as an adjunctive, rather than stand alone therapy (2). Advances in technology have changed the landscape of available EMS applications and options. Variations of conventional low frequency intravagnal EMS, are now available through mHealth applications that can be independently used at home. Novel, surface or extravginal applications of EMS notably, high frequency electromagnetic stimulation, has been proposed as an effective “non-invasive” alternative to intravaginal EMS (3). The purpose of this study was three fold: 1) To review the current efficacy of EMS for female pelvic floor dysfunction; 2) To describe the efficacy of intravaginal EMS and extravaginal EMS, 3) To describe the efficacy of low frequency EMS and high frequency specifically for female pelvic floor dysfunction.