Effect of electrical stimulation on stress and urge urinary incontinence. Clinical outcome and practical recommendations based on randomized controlled trials.

BACKGROUND The aim of the present study was to review the literature on randomized controlled trials of electrical stimulation to treat urge and stress urinary incontinence. METHODS Studies were compiled from Medline from 1980 till 1996 and manual searches of relevant journals. Randomized controlled studies full length published in English, German and Scandinavian languages were included. RESULTS Nine studies evaluating the effect of electrical stimulation on stress urinary incontinence and one study evaluating the effect of urge incontinence were found. Only three studies had a sufficient sample size to enable conclusion on stress urinary incontinence. Two demonstrated negative, and one positive effect (20%) cure and 46% improved measured by pad test). The study on urge incontinence demonstrated that there was no difference in effect after electrical stimulation or anticholinergic drugs. CONCLUSION The results of randomized controlled trials evaluating the effect of electrical stimulation to treat stress and urge urinary incontinence are conflicting. There is a need for more randomized controlled trials with sufficient sample sizes, use of sensitive, reproducible and valid outcome measures, and optimal stimulation parameters. Based on the present knowledge pelvic floor muscle exercise should be the first choice of treatment for stress urinary incontinence.