Expert opinion: Could the Emsella chair solve our pelvic floor and incontinence issues?

By Tom Peterson On Sep 17, 2022 54 0

It’s being hailed as the ‘kegel throne’ or, its official name, Emsella — and while the option of a walk-in walk-out treatment that’s painless and convenient is alluring for so many women suffering one of the last female health taboos — urinary incontinence — you need to know it’s the right treatment for you, say the experts.

he supercharged FDA medically-approved chair works by stimulating the pelvic floor muscles with high-intensity focused electromagnetic energy. This lasts for six sessions over multiple weeks with two sessions a week and costs up to €1,800. So how do you know if this exercise-free option will work for you?

Dr Rita Galimberti, medical director of Femplus

Dr Rita Galimberti, medical director of Femplus, a women’s health clinic based in Blanchardstown, says: “My main issue is that I’m not sure it’s done in the correct setting. You see it in some cosmetic clinics with no offer of a medical assessment or examination.

“For example, what happens if the women haven’t been assessed by an expert? Well, some think they have stress incontinence, but might have urge incontinence which is a completely different treatment and is not treated by pelvic floor improvement.

“Then you also have some women who might already have a strong pelvic floor but leak because of other issues with support tissues around the urethra. Again, in this case, it is not the right treatment. Or if somebody already has a hypertonic pelvic floor (which can cause friction and urethral trauma, giving symptoms like an infected urinary tract though it’s not an infection) — they could get much worse. So, you can spend a lot of money on a treatment which is never going to work, or unintentionally make your condition worse.

“This is why I urge anyone with bladder issues to get assessed to determine what the most likely main diagnosis is first — either from your doctor, pelvic floor physical therapist, gynaecologist, urologist, or urogynaecology,” says Dr Rita, a specialist in obstetrics and gynaecology.

The Consultant Obstetrician and Gynaecologist

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Dr Gerry Agnew specialises in urogynaecology and pelvic floor reconstructive surgery

Consultant Obstetrician and Gynaecologist at the National Maternity Hospital, Dr Gerry Agnew, who specialises in urogynaecology and pelvic floor reconstructive surgery welcomes the advancement that the Emsella chair offers.

“Here is a system that offers the chance to optimise the strengthening and toning of your pelvic floor. Life is hectic and women can find it difficult to devote time to performing their pelvic floor exercises.

“Choosing Emsella is a commitment to a programme of intensive pelvic floor stimulation over a set period of time. I’m a big fan of anything that is going to improve womens’ access to pelvic floor health.

“However, in my opinion an initial assessment by a womens’ health physiotherapist is a must. Not all pelvic floor problems can be treated in the same manner. It is vital that hypertonic (excessively tight, non relaxing) pelvic floor muscles for instance, are correctly diagnosed and not treated blindly with further stimulation. I also feel that improvements in stress incontinence with Emsella are likely to be mild and short lasting.

“In my experience, significant stress incontinence ultimately requires some form of surgical intervention. Minimally invasive treatments such as bulking agents have far greater scientific evidence to support their use at the present time than Emsella.”

The Pelvic Health Physiotherapist

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Aoife Harvey, pelvic health physiotherapist at The Grange Clinic

Aoife Harvey, from The Grange Clinic in Dublin 13, who is a passionate advocate for women’s pelvic health, agrees: “While I am glad to hear leakage being talked about so openly, there are some questions you need to ask.

“Can it help to strengthen your pelvic floor muscles by sitting on it? In short, yes. Can this help symptoms of leakage? For some women, yes. Will it help with sexual function? Perhaps for some.

“The main problem for me is the chair is usually located in aesthetic clinics where you will not receive an assessment from an expert in this field. You will answer some questions about your symptoms, but does the provider specialise in urinary incontinence and pelvic health?

“When you come to see an expert physiotherapist, we take a detailed history of your diet, fluids, childbirth, hormones, bowel habits, activity levels and many in-depth questions about your leakage — when it happens, how often, how much, when it started. We do an internal assessment in most cases, so we can feel the tone in your pelvic floor muscles via your vagina — deep and superficial layers, left side and right.

“I understand people want quick, effective results but I strongly recommend you find out the cause of your symptoms first,” concludes Aoife.

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