Transcutaneous pudendal nerve stimulation for refractory urinary incontinence: A viable option?

According to international recommendations pelvic floor exercises represent the first conservative intervention to be offered to patients with non-neurogenic urinary incontinence. Transcutaneous electrical stimulation of the pudendal nerve using sticking electrodes has not been extensively studied so far and is not mentioned in the European guidelines. Physiology suggests that it might be a viable option to treat incontinence refractory to pelvic floor exercises. To investigate the effects of transcutaneous electrical stimulation of the pudendal nerve in a sample of patients of both genders with urinary incontinence refractory to pelvic muscle exercises. Prospective pilot study on a convenience sample, assessed with 24 h pad-test. Twenty-four patients (18 male, six female) were enrolled. Pre-treatment urinary leakages with sacral root stimulation were Me = 230 g, IQR [90;305], range 50-500. Post-treatment urinary leakages had a median of 55 g, IQR [10;137], range 0-400 (p < 0.0001). Transcutaneous pudendal nerve stimulation is an effective, non-invasive treatment that deserves studies on larger samples.