Objective: To determine the efficacy and safety of transvaginal pelvic floor stimulation in the treatment of women with genuine stress incontinence and detrusor instability complicated by a low-pressure urethra. Methods: Twenty-six consecutive women with mixed incontinence complicated by a low- pressure urethra who elected to try pelvic floor stimulation were studied. Visual analogue symptom scales and weekly incontinence episodes were compared before and after 8 weeks of twice-daily device use. Results: The symptoms of stress and urge incontinence were completely resolved in six (23%) and ten (38%) women, respectively. Ten of 26 subjects (38%) had greater than 50% overall symptomatic improvement, and two subjects (8%) were completely dry during their last week of therapy. Symptoms of urinary frequency, urgency, and stress incontinence improved significantly. No factors were found to be predictive of treatment success. Conclusion: Pelvic floor stimulation was found to be an effective and safe treatment for some patients with genuine stress incontinence and detrusor instability complicated by a low-pressure urethra.
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