Electrical stimulation can treat urinary incontinence by delivering controlled signals to the muscles and nerve pathways involved in bladder control. But not every electrical signal has the same effect. The placement of the electrodes, signal frequency, waveform, intensity and timing must all be designed for the particular type of incontinence being treated.
Updated: August 14, 2026
Author: Elitone Medical Staff
Electrical stimulation for incontinence uses carefully controlled electrical signals to activate muscles or influence nerve pathways involved in storing and releasing urine. Depending on the treatment program, the signals may produce pelvic floor contractions, help inhibit unwanted bladder contractions or combine both effects.
The principle is similar to the way the nervous system normally controls the body. Your brain and nerves communicate with muscles through electrical impulses. An appropriately designed stimulation device supplies an external signal that can activate targeted tissues even when a person has difficulty consciously finding, contracting or coordinating those muscles.
Electrical stimulation has been used in pelvic floor rehabilitation for decades. Traditionally, much of this treatment required an inserted vaginal or rectal probe or repeated visits to a clinic. Transcutaneous devices provide stimulation through electrodes placed on the skin, allowing treatment to be delivered without an inserted component.
Urinary continence depends on coordinated activity among the bladder, urethral sphincter, pelvic floor muscles, spinal cord and brain. Electrical stimulation can affect this system in two principal ways:
These mechanisms are different, even though both involve electrical stimulation. A signal intended to contract and condition muscle should not be assumed to have the same effect as a signal intended to calm an overactive bladder.
Electrical-stimulation terminology can be confusing because the terms are sometimes used loosely.
These categories describe the general purpose of electrical stimulation, but they do not fully describe the signal a device delivers. Two devices may both use surface electrodes while differing substantially in waveform, carrier signal, pulse characteristics, intensity, electrode geometry and anatomical placement.
In everyday use, the term “TENS machine” is also sometimes applied broadly to inexpensive or general-purpose electrical stimulators, even when the device is technically being used for muscle stimulation rather than pain relief. This can make comparisons misleading.
For transcutaneous pelvic floor stimulation, an important consideration is how the therapeutic signal crosses the skin and reaches the intended muscles or nerve pathways. Elitone’s Pre-modulated waveforms (PMW) use a high-frequency carrier signal to help deliver a lower-frequency therapeutic modulation through the skin while maintaining a tolerable sensation at the surface.
A general-purpose TENS or EMS unit should therefore not automatically be considered equivalent to a device engineered for bladder leakage. The waveform, output, electrode design, anatomical placement and treatment program all need to be appropriate for the intended tissue and medical condition. A device cleared for pain relief or general muscle conditioning is also not necessarily FDA-cleared to treat urinary incontinence.
Electrical current travels between conductive electrode regions. Their location, size and spacing help determine which tissues lie within the current path. Therefore, placing ordinary electrodes somewhere near the pelvis does not necessarily target the muscles and nerves involved in continence.
Elitone uses a flexible GelPad placed externally against the perineal area, where a conventional bladder-leak pad would ordinarily be worn. Four conductive hydrogel regions are positioned to direct stimulation through the pelvic floor muscles and surrounding tissues. The GelPad’s shape helps make that placement repeatable from one treatment session to the next.
The conductive hydrogel also performs two important functions: it holds the electrode against the skin and creates a low-impedance connection through which the stimulation can be delivered. Distributing the current across multiple conductive regions helps provide more even stimulation than would be expected from very small, concentrated electrodes.
The skin and tissue between a surface electrode and the pelvic floor create electrical resistance, also called impedance. This has historically been one of the challenges of external pelvic floor stimulation: simply increasing the output of a conventional electrical signal can increase sensation at the skin before sufficient stimulation reaches the intended muscles and nerves.
Elitone addresses this challenge with its proprietary Pre-Modulated Waveform (PMW). Elitone’s PMW combines the therapeutic treatment signal with a high-frequency carrier signal before the stimulation reaches the electrodes. Because skin impedance decreases as electrical frequency increases, the high-frequency carrier helps the treatment signal pass through the skin and soft tissue more efficiently and comfortably.
The carrier signal itself is not the therapeutic treatment frequency. Instead, it acts as a delivery mechanism for the lower-frequency modulation that is intended to produce the desired muscle or nerve response.
This distinction helps explain why modern transcutaneous pelvic floor stimulation can differ substantially from a conventional surface electrical stimulator. Effective treatment depends not only on intensity, but on the waveform, carrier signal, electrode geometry, anatomical placement and therapeutic stimulation pattern working together.
A balanced, symmetric waveform can also help limit net direct-current buildup at the skin-electrode interface, an important consideration for comfort during repeated treatments.
No single electrical specification determines whether a stimulation device will work. Effective transcutaneous stimulation depends on several parameters operating together.
Two devices can both be described as “electrical stimulators” while delivering substantially different treatments. Frequency alone also does not describe the complete signal. The waveform, amplitude, phase duration, treatment timing and anatomical placement must be considered together. This is why comparing devices simply by calling them TENS or EMS units can obscure important differences in how their stimulation is actually delivered.
Stress and urge incontinence involve different bladder-control problems, so Elitone and Elitone Urge use different stimulation programs.
| Technology feature | Elitone | Elitone Urge |
|---|---|---|
| Primary treatment objective | Activate and condition the pelvic floor muscles while also providing a brief calming signal | Influence bladder-control pathways and help calm involuntary bladder activity |
| Therapeutic frequencies | 50 Hz muscle-contracting signal followed by a 10 Hz calming signal | 10 Hz calming signal |
| Stimulation cycle | 4 seconds at 50 Hz, 2 seconds at 10 Hz and 6 seconds of rest | 6 seconds at 10 Hz followed by 6 seconds of rest |
| Typical sensation | Rhythmic pelvic floor contractions with periods of rest | Tingling or pulsing without the same strong repeated contractions |
| Session length | 20 minutes | 20 minutes |
| External placement | Perineal GelPad | Perineal GelPad |
During a 20-minute Elitone session, the 12-second cycle repeats 100 times. This produces 100 pelvic floor contraction and rest cycles—doing Kegels for you longer and stronger. The rest interval is important because a continuous contraction would promote fatigue rather than repeated muscle training.
Elitone Urge does not attempt to produce the same pelvic floor workout. Its lower-frequency signal is designed for the different objective of reducing urgency-related bladder activity.
Electrical neuromodulation is already used to treat overactive bladder through sacral nerve stimulation and tibial nerve stimulation. Although these treatments deliver stimulation at different anatomical locations, they are intended to influence the nerve pathways that regulate bladder storage and urgency.
Elitone Urge delivers a 10 Hz signal through an external perineal GelPad. This is within the same general low-frequency range used by established bladder neuromodulation treatments. Sacral neuromodulation commonly uses frequencies around 10-14 Hz, while percutaneous tibial nerve stimulation commonly uses approximately 10-20 Hz. These similarities support the rationale that Elitone Urge works through neuromodulation rather than through repeated pelvic floor strengthening.
The treatments are not equivalent, however. They access the bladder-control system in different ways:
| Treatment | Stimulation location | Common frequency | How treatment is delivered |
|---|---|---|---|
| Elitone Urge | External perineal area | 10 Hz | Wearable GelPad placed on the skin |
| Percutaneous tibial nerve stimulation (PTNS) | Tibial nerve near the ankle | Approximately 10-20 Hz | Needle electrode used during repeated office treatments |
| Sacral neuromodulation | Sacral nerve, typically near S3 | Commonly around 10-14 Hz | Surgically implanted lead and pulse generator |
The tibial, pudendal and sacral nerve pathways ultimately connect with the spinal circuits involved in bladder control. Stimulation at any one of these locations may influence those circuits and help inhibit involuntary bladder activity. However, similar treatment frequencies do not prove that the devices produce identical physiological effects or clinical outcomes.
Elitone Urge’s distinction is that it provides non-invasive neuromodulation at home without an implanted device, ankle needle or repeated office procedure.
Elitone is classified by the FDA as a transcutaneous electrical continence device. “Transcutaneous” means that the signal is delivered through the skin. No vaginal or rectal probe is inserted.
The treatment system consists of a rechargeable controller and a flexible GelPad with four conductive regions. The controller automatically delivers the programmed waveform and treatment cycle, so the user does not need to select frequencies, calculate treatment timing or manually contract the pelvic floor.
Each treatment lasts 20 minutes. Because the thin GelPad is worn externally and the controller is portable, treatment can be completed while dressed and moving around during ordinary activities.
Elitone, Elitone Urge and Elitone for Men share an external treatment approach, but they are not interchangeable. Each device has a specific program and FDA-cleared intended use. Users should select the product that matches their type and cause of leakage.
Traditional pelvic floor electrical stimulation is often delivered through a vaginal or rectal probe positioned close to the pelvic floor muscles. This can provide direct stimulation but requires insertion and is ordinarily performed while the user is sitting or lying down.
External transcutaneous stimulation delivers the signal through electrodes placed on the skin. Its potential advantages include:
External and internal stimulation should not be evaluated solely by the location of the electrode. Effectiveness also depends on whether the current reaches the intended tissues, the treatment waveform is appropriate, the device is used consistently and the person’s symptoms match the device’s intended use.
Although an internal probe places the electrode physically closer to some pelvic floor tissues, greater depth does not necessarily mean more effective stimulation for urinary incontinence. The muscles and nerve pathways involved in urethral support and closure are not located only deep within the vaginal canal. Transcutaneous systems can use waveform design, high-frequency carrier signals, sufficient treatment intensity and carefully positioned electrodes to deliver stimulation through the skin and focus the electrical field on the pelvic floor tissues around and supporting the urethra. The relevant question is whether the treatment produces the intended physiological response at an effective and tolerable intensity.
At lower settings, electrical stimulation may feel like tingling, tapping or a soft rhythmic pulsing. As the intensity of Elitone is increased, the user should feel the pelvic floor muscles contract and release. Elitone Urge generally produces a milder pulsing sensation without the same repeated muscle contractions.
The objective is to reach a strong but comfortable setting. Treatment should not be painful. Sensation can vary with placement, skin condition, body position and GelPad contact. If stimulation feels sharp, uneven or uncomfortable, the user should pause treatment, check the GelPad placement and follow the instructions for use before continuing.
Electrical stimulation has been studied as a conservative treatment for urinary incontinence using internal probes, external electrodes and other neuromodulation approaches. However, findings from one device or electrode location should not automatically be applied to every other electrical-stimulation product.
Elitone has been evaluated specifically as an external, perineal neuromuscular stimulation device. Clinical studies have used leak diaries, pad-weight testing, pad use, validated quality-of-life measures and ultrasound visualization of pelvic floor movement.
In a six-week study of women with stress urinary incontinence, 95% of participants reported fewer leaks and average leakage decreased by 71%. Ultrasound evaluation has also provided objective evidence that Elitone produces pelvic floor contraction, including in a participant who was unable to produce an effective voluntary Kegel contraction.
Elitone Urge was studied separately in women with urge urinary incontinence. Because its patient population and stimulation program differ, those results should be evaluated independently from studies of the stress-incontinence device.
For study descriptions and additional clinical findings, visit The Science Behind Elitone. Individual results vary.
Electrical stimulation should match the type of bladder-control problem being treated:
If you are uncertain which symptoms you have, review the different types of urinary incontinence or consult a healthcare professional before selecting a device.
Electrical stimulation is not simply one universal technology. Effective treatment requires the right electrode placement, waveform, frequency, intensity, duty cycle and medical indication. Elitone brings these elements together in an external, wearable system designed specifically for urinary incontinence treatment.
Neuromuscular electrical stimulation can activate the motor nerves that control the pelvic floor, producing a contraction without requiring the user to perform a voluntary Kegel. Elitone’s pelvic floor contraction has also been visualized using ultrasound.
Not exactly. A voluntary Kegel begins with a signal from the brain, while NMES supplies an external signal that activates the neuromuscular system. Both can produce pelvic floor contractions, but electrical stimulation can be helpful when someone cannot identify, coordinate or consistently exercise the correct muscles.
No. Elitone is not simply a general-purpose TENS machine.
TENS commonly refers to transcutaneous electrical stimulation used for pain relief, but the term is also often used loosely for inexpensive surface electrical stimulators. Devices that all use electrodes on the skin can still differ substantially in waveform, carrier wave, intensity, electrode configuration, anatomical placement and treatment program.
Elitone uses its proprietary Pre-Modulated Waveform (PMW) with a high-frequency carrier signal to help deliver the therapeutic stimulation through the skin and soft tissue at an effective, comfortable intensity. Its waveform, electrode design, placement and treatment parameters are specifically engineered for urinary incontinence.
So the fact that Elitone is transcutaneous does not make it equivalent to a conventional TENS or EMS unit.
An ordinary stimulator may not have the appropriate waveform, output limits, electrodes, placement instructions or FDA-cleared indication for treating urinary incontinence. Do not place general-purpose electrodes on the genital or perineal area unless the device is specifically designed and labeled for that use.
Elitone’s proprietary Pre-Modulated Waveform (PMW) combines its therapeutic treatment signal with a high-frequency carrier wave. Because skin impedance decreases as electrical frequency increases, the carrier signal helps the treatment signal pass through the skin and soft tissue more efficiently and comfortably.
The high-frequency carrier waveform is a delivery mechanism. The lower-frequency therapeutic modulation is what is intended to produce the desired muscle or nerve response.
Yes. Elitone is designed to deliver electrical stimulation through the skin and soft tissue to the muscles and nerve pathways involved in bladder control.
The skin creates electrical impedance that can make external stimulation more difficult. Elitone addresses this with its proprietary Pre-Modulated Waveform (PMW), which uses a high-frequency carrier wave to help deliver the therapeutic signal through the skin at an effective and tolerable intensity.
Waveform design is only part of the system. Elitone’s treatment intensity, GelPad electrode geometry and perineal placement also help direct stimulation to the intended pelvic floor tissues.
Not necessarily. An internal probe is physically closer to some pelvic floor tissues, but distance or depth alone does not determine effectiveness. For urinary continence, the goal is to stimulate the muscles and nerve pathways involved in supporting and closing the urethra. Elitone’s external electrode placement, waveform and treatment intensity are designed around that anatomical target rather than simply trying to deliver stimulation as deeply as possible.
One of the main challenges is the skin. A surface electrode must deliver the electrical signal through the skin and soft tissue before reaching the target muscles and nerves. With conventional stimulation, increasing intensity can produce stronger sensation at the skin before sufficient stimulation reaches the intended tissue.
Historically, one solution was to place electrodes closer to the pelvic floor using vaginal or rectal probes.
Elitone takes a different approach. Its proprietary Pre-Modulated Waveform (PMW) uses a high-frequency carrier wave to help deliver the therapeutic signal through the skin more efficiently and comfortably, allowing pelvic floor stimulation without an internal probe.
Elitone alternates stimulation with rest so the pelvic floor can relax between contractions. This helps limit fatigue and allows the 12-second treatment cycle to repeat 100 times during a 20-minute session.
Urge incontinence is associated with involuntary bladder activity rather than simply insufficient pelvic floor support. Elitone Urge therefore uses a 10 Hz program intended to calm the bladder-control pathways instead of repeatedly contracting the pelvic floor.
Yes. Elitone is FDA-cleared to treat stress urinary incontinence in women. Elitone Urge has a separate clearance for urge urinary incontinence, and Elitone for Men is cleared to aid early continence recovery immediately following prostate surgery. Read more about what Elitone’s FDA clearance means.
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