Electric stimulation: does nursing have a role in the treatment of adult urinary incontinence?

Collection devices are still the most common alternative patients use in coping with urinary incontinence. Encouraging results exist for increasing potential curative effects with electric stimulation, yet many are skeptical and undervalue its positive potential, especially in the United States. In the United Kingdom and Sweden it is considered a low-cost treatment with few side effects. Patients can use it for short periods of time in the clinic or at home for long-term or intermittent maintenance therapy. Commercial devices on the market are technically reliable and can be safely and easily used to treat different types of incontinence. Studies report subjective and objective successful treatment outcomes with a single or a combination of behavioral approaches, primarily pelvic floor exercises, cones, bladder training, biofeedback, and electric stimulation. There definitely is a need to determine the efficacy of electric stimulation with controlled research, each having similar stimulation parameters to compare outcomes. At this time, no one knows precisely what treatment modality a particular patient will best respond to; however, the range of improvement and cure rates are similar for a number of approaches, used singly or in combination. To add electric stimulation to a treatment program can maximize the potential for continence. The nurse's role involves being knowledgeable about the therapeutic use of electric stimulation and being thorough and competent in performing initial and ongoing patient examinations and assessments in collaboration with other health care providers. In planning a treatment program individualized to meet patient needs, the patient ultimately makes the choice after learning about the advantages and disadvantages of each.