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Pelvic Floor & Bladder
Does Emsella Work?
In brief
Emsella uses high-intensity focused electromagnetic energy to produce pelvic floor contractions far beyond what voluntary exercise achieves. Published research reports improvement in bladder control and quality of life for many of the patients studied. The trials are small, and results vary. Evaluation comes first.
What the research shows
HIFEM technology has been studied for pelvic floor weakness and urinary incontinence, with published findings reporting improvement in symptom and quality-of-life scores for a meaningful share of participants across a course of sessions.1,2
It is worth knowing how big that evidence base actually is. The most-cited study followed 75 women and had no control group.1 The strongest trial we are aware of is a randomised study of 44 women, funded by a national research council rather than by the manufacturer, which found better bladder scores and measurably stronger pelvic floor contraction when HIFEM was added to pelvic floor exercise.2 Several other published trials were sponsored by the company that makes the device. None of that makes the findings wrong. It does mean the honest summary is "promising, and worth evaluating" rather than "proven."
Those are findings, not promises. Study populations are not individual patients, results vary, and nothing here guarantees a particular outcome. What the evidence supports is that this is a reasonable option worth evaluating.
Why it can work
The pelvic floor is muscle, and muscle responds to repeated contraction. The difficulty is doing it correctly and often enough to matter. In the study that first measured this, fewer than half of women achieved an ideal contraction after brief verbal instruction, and a quarter were bearing down — a technique that can make leakage worse rather than better.3 Careful, hands-on teaching fixes most of that,4 which is why we teach it properly before reaching for anything else.
A single 28-minute session produces thousands of supramaximal contractions. That is the mechanism: volume and accuracy that voluntary exercise struggles to reach. See Emsella compared with kegels.
Who it is worth evaluating for
- Bladder leaks with laughing, coughing, sneezing, or lifting
- Urgency and frequency
- Pelvic floor weakness after childbirth
- Changes that arrived with menopause
- Men after prostate procedures
Why bladder symptoms and menopause travel together
Declining estrogen affects the pelvic floor and urogenital tissue. That is why bladder symptoms so often appear alongside the other changes of the menopause transition, and why we look at both rather than treating one in isolation.
What happens first
We evaluate before recommending anything. Some symptoms have causes that need addressing separately, and some patients are better served another way. Read about Emsella at ACWH.
This article is educational and is not medical advice. Treatment options may be available when clinically appropriate. Results vary from person to person.
References
- Samuels JB, Pezzella A, Berenholz J, Alinsod R. Safety and efficacy of a non-invasive high-intensity focused electromagnetic field device for treatment of urinary incontinence and enhancement of quality of life. Lasers Surg Med. 2019;51(9):760–766. Open-label, single-arm, 75 participants, no control group; outcomes were a symptom questionnaire and pad count.
- Kılıçöz Bakar M, Özkoçak G, Algun ZC. Comparison of high-intensity electromagnetic therapy and pelvic floor muscle exercises in women with urinary incontinence: a randomised controlled trial. Int J Womens Health. 2026;18:1–14. Randomised, 44 participants, funded by TÜBİTAK with no manufacturer involvement; measured EMG activity as well as symptom scores.
- Bump RC, Hurt WG, Fantl JA, Wyman JF. Assessment of Kegel pelvic muscle exercise performance after brief verbal instruction. Am J Obstet Gynecol. 1991;165(2):322–329. 49% achieved an ideal contraction; 25% used a technique that could worsen incontinence. 47 participants.
- Weinert K, Keim U, Wawers A, Gärtner-Tschacher N, Plappert CF. Influence of structured teaching on targeted pelvic floor muscle contraction ability in pregnant women: the pelviTrust trial. Healthcare. 2026;14(5):651. After structured teaching, 97% achieved a correct contraction.
- National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Definition and facts for bladder control problems.
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This article is educational and is not medical advice. It does not create a patient relationship. Treatment options may be available when clinically appropriate, and results vary from person to person. If you are experiencing a medical emergency, call 911.