Transperineal Ultrasound Evaluation of Intravaginal Electrical Stimulation Parameters

Area of Science:

• Urogynecology
• Pelvic Floor Physical Therapy
• Medical Device Technology

Background:

• Pelvic organ prolapse (POP) affects many women, impacting pelvic floor muscle (PFM) function.
• Intravaginal electrical stimulation (IVES) is a therapeutic option for PFM dysfunction.
• Identifying optimal IVES parameters is crucial for treatment efficacy.

Purpose of the Study:

• To determine the most effective vaginal region for IVES to stimulate PFM.
• To assess the impact of IVES on levator hiatus (LH) dimensions using transperineal ultrasound (TPUS).
• To evaluate the feasibility and patient acceptability of concurrent IVES and TPUS.

Main Methods:

• An open-label, cross-sectional study involving women with POP.
• IVES was applied using a NeuroTrac® Continence device at varying depths within the vagina.
• TPUS was simultaneously used to measure LH length, with reductions indicating PFM contraction.

Main Results:

• Maximum voluntary PFM contraction resulted in a 5.75% LH length reduction.
• IVES applied near the posterior fornix (0-2 cm distal) yielded the greatest LH length reductions (10.83% and 10.17%).
• Stimulation further from the posterior fornix showed progressively smaller reductions in LH length.

Conclusions:

• The optimal region for IVES to achieve maximal PFM response is near the posterior fornix.
• Concomitant use of IVES and TPUS is a feasible method for evaluating PFM response to stimulation.