Leaking urine is called "incontinence". Stress urinary incontinence (SUI), is another common
bladder problem. It's different from OAB. People with SUI leak urine while sneezing, laughing
or doing other physical activities. If you have an overactive bladder, you may feel
embarrassed, isolate yourself, or limit your work and social life.
Overactive bladder (OAB) is a very common clinical condition, with an overall prevalence
estimated at 11.5% in the general population of Pakistan.
In traditional medicine and recent years, nerve stimulation has been introduced as a
replacement therapy for managing several disorders such as overactive bladder. However, there
is still controversy in this regard. Therefore, the present study is aimed to find out the
effectiveness of Electric Muscle Stimulation and Transcutaneous Electric Nerve Stimulation in
treatment of overactive bladder.To overcome this controversy we need to do this study in
Pakistan and find out whether there is any role of EMS and TENS in the management of OAB.
OAB is one of the important conditions that lead to the limitation in activity and
participation due to dribbling, urgency and frequency of urination. According to literature
review there is a strong linkage between OAB rehabilitation and improvement of patient
symptoms. The Neuromodulation plays a significant role in the management of OAB. The proper
task specific rehabilitation not only improves the functional status of a person rather it
enhances the quality of life and their active role in community. In routine rehabilitation
main focus is always on the role of pelvic floor exercises but Neuromodulation is still
neglected in treatment regimen of OAB in Pakistan. The patients will profit in better help of
manifestations if Neuromodulation intervention is applied that is upheld by proof for the
treatment of OAB. The consequences of the investigation will be useful for the Physical
Therapists in planning and picking best treatment approach for the treatment of OAB.
TENS is based on the gate control theory of abolishing the local micturition reflex arc. It
is a non-pharmacological method of inhibiting the presynaptic afferent neurons carrying
impulses from bladder by stimulating the nerves of peripheral segmental dermatome (gate
control theory of electro modulation by stimulating the peripheral nerves corresponding to
the visceral organ). It acts at the level of primitive voiding reflex coordinating the
bladder, sphincter and the pelvic floor. Detrusor hyperreflexia can be inhibited by direct
inhibition of impulses in the preganglionic afferent neuron or by inhibition of bladder
preganglionic neurons of the efferent limb of micturition reflex.
EMS is also believed to produce some inhibition of the bladder, allowing the bladder to reach
a greater volume. This is believed to occur because electrical stimulation also stimulates
nerves in the pelvic floor. In most people, bladder voiding is inhibited when the skin of the
pelvis is touched or otherwise manipulated. This inhibition is via a reflex in the spinal
cord that may have evolved to inhibit voiding during sexual contact. The pelvic floor nerves
are responsible for transmitting the sensation of touch from the pelvis to the spinal cord.
Electrical stimulation of these nerves thus activates sensory fibers that cause inhibition of
bladder voiding via a reflex mechanism in the spinal cord. This may explain EMS is an
effective treatment for people with incontinence.