Treatment of Stress Incontinence by Maximum Perineal Electrical Stimulation

Abstract

Stress incontinence of urine in the female is usually due to loss of tone of the pelvic floor muscles with consequent shortening of the urethra. In the erect posture the urethra must be at least 3 cm. long. Cases were treated by causing maximal contraction of these muscles by electrical stimulation under general anaesthesia. Of 18 cases so treated 33% were completely relieved and 22% much improved. During contraction of the pelvic floor muscles the urethra lengthens by 1 cm. or more, to return to its previous length when the contraction ceases. It is suggested that in the successful cases the maximal perineal muscle electrical stimulation has restored the postural tone of the pelvic floor, so that all increases of intra-abdominal pressure are again accompanied by the normal pelvic floor contraction and lengthening of the urethra. Possibly one maximum contraction of a muscle restores power better than repeated submaximal contractions, the more usual method. This treatment should always be tried before operative measures are advised, particularly when investigation has shown that in the erect posture the urethra is only 1 cm. or less short of the critical length (3 cm.). © 1967, British Medical Journal Publishing Group. All rights reserved.