Chair-Based Magnetic Pelvic Floor Stimulation and Female Sexual Function in Women with Urinary Incontinence: A Systematic Review

Abstract

Background and objectives: Urinary incontinence (UI) frequently coexists with female sexual dysfunction (FSD). Magnetic chair therapies—high-intensity focused electromagnetic stimulation (HIFEM) and extracorporeal magnetic innervation (ExMI)—are increasingly used for UI, but sexual outcomes are less well synthesized. We reviewed open-access clinical studies reporting Female Sexual Function Index (FSFI) and/or Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ) outcomes. Methods: Following PRISMA 2020 and an OSF-registered protocol, we searched PubMed, Scopus, and Web of Science to 25 October 2025. Eligible studies enrolled adult women with UI, used chair-based magnetic stimulation, and reported FSFI and/or PISQ before and after treatment. Data were narratively synthesized. Results: Five studies (n ≈ 219; FSFI n ≈ 170; PISQ n = 49) met the criteria. Randomized and controlled data showed clinically relevant advantages for active therapy: FSFI between-group gains were +6.3 at 8 weeks for HIFEM+PFMT vs. PFMT and +5.63 at 14 weeks for pulsed magnetic stimulation vs. sham. Single-arm cohorts reported FSFI increases of +8.1 at 3 months and +9.4 to +10.0 by ~6–12 months. PISQ-12 improved by +3.86 at 12 weeks when magnetic stimulation was combined with optimized PFMT. UI severity also decreased (ICIQ-UI SF −9.85; 74.4% at 12 weeks; ~71–72% reduction at 9–12 months). Adverse events were uncommon and mild where reported. Conclusions: Across heterogeneous designs, chair-based magnetic stimulation is associated with meaningful improvements in sexual function and continence in women with UI, with signals that combining stimulation with PFMT may enhance benefits. Standardized, longer-term trials centered on FSFI/PISQ are warranted.