Pelvic floor muscles High-Intensity Tesla Stimulation

Abstract

Introduction: Stress urinary incontinence (SUI) represents a significant health problem for women, which fundamentally reduces the quality of life. Conservative treatment mainly includes pelvic floor muscle training, where the effectiveness is limited by the patient’s ability to actively engage the muscles and long-term compliance. An alternative is electrical stimulation of the pelvic floor, which, however, is sometimes painful and requires invasive application of probes to the pelvic floor. A new option is high-frequency electromagnetic stimulation using High-Intensity Tesla Stimulation (HITS) technology, which induces intense muscle contractions without the need for insertion of probes or electrodes and with higher patient tolerance. The aim of the study was to evaluate the effectiveness of six HITS sessions in women with SUI – based on subjective assessment by patients and objective assessment of muscle strength according to the modified Oxford scale (MOS) and electromyographic activity of the pelvic floor using the Multiple Array Probe Leiden (MAPLe) probe). Methods: A prospective study was conducted at the urogynecological center Gyn-Line in Brno from February to September 2025. Twenty women with urodynamically proven SUI who did not wish to undergo surgical treatment of the disease were included. Patients underwent six sessions of high-frequency electromagnetic stimulation HITS on the MagRex Pelvic Seat device over 4–5 weeks. The protocol included contractions at frequencies of 25 Hz, 35 Hz, and 35–75 Hz according to tolerance. Evaluation of effectiveness included MOS, electromyographic activity of the pelvic floor muscles measured by the MAPLe probe, and a subjective Patient Global Impression of Improvement (PGI-I) questionnaire. Statistical analysis was performed using a Student’s t-test at a significance level of P < 0.05. Results: All patients (N = 20; age 62.5 ± 9.4 years; parity 2.4 ± 2.7; BMI 29.2 ± 6.4 kg/m²; 90% postmenopausal) completed the series of six sessions without adverse effects. The procedure was evaluated as painless and well tolerated. Muscle strength according to MOS increased from 2.4 to 3.8 (increase of 58.3%). Electromyographic activity of the pelvic floor muscles measured by MAPLe increased from 7.0 to 9.9 μV/s (increase of 41.4%). Subjective assessment according to PGI-I improved from 4.0 to 5.9 (increase of 47.5%). All differences were statistically significant (P < 0.05). Conclusion: The results demonstrated that high-frequency electromagnetic stimulation HITS of the pelvic floor is a safe and effective method of conservative treatment of stress urinary incontinence in women. This therapy led to statistically significant improvement in muscle strength assessed by the Oxford scale, electromyographic activity of the pelvic floor according to MAPLe, and also subjective perception of difficulties by patients. HITS may thus represent as an alternative or adjunct therapy to traditional pelvic floor muscle training. To confirm long-term efficacy, larger randomized clinical studies are recommended.