Dr. Ruth Maher on Using Electrical Stimulation to Strengthen the Pelvic Floor

Dear Dr. Ruth,

I’ve tried doing Kegels on my own and they don’t seem to help with leakage issues. I’m considering INNOVO, but before I make the purchase I’m trying to figure out how electrical stimulation works to induce Kegels versus just doing them on my own. Can you explain this technology and whether it’s worth it for me?


Curious and Still Leaking


Dear Curious and Leaking,

Great question—and one I am happy to answer! I had my own practice for several years in Atlanta and then later in Ireland. I became frustrated because many women couldn’t perform voluntary contractions even with appropriate instruction. They had no awareness of how to recruit these muscles. When trying to perform contractions, they frequently contracted other muscles—their glutes or abdominals.

I thought electrical stimulation was misunderstood and underutilized. It was being used with little probes that look like tampons, but the results were equivocal. The problem with stimulation using the probes was that women would say they felt a contraction, but using ultrasound imaging, I could see that for many, the stimulation did not elicit a pelvic floor contraction. They’d say, “I can feel a contraction,” and I couldn’t see any evidence of a pelvic floor contraction. With the probe stimulation, I noted that when using ultrasound imaging I could confirm a pelvic floor contraction in only 32 percent of women despite their reporting the sensation of a contraction.

During my PhD studies at University College Dublin, I had an opportunity to use a unique stimulation platform called Multipath, which has since been patented and trademarked. Multipath uses multiple pathways to send stimulations to muscle. I used eight large electrodes around the pelvis and on the upper thighs and developed a program that sends electrical stimulation via different pathways across the pelvis. My program elicited pelvic floor muscle contractions—which I validated using ultrasound imaging—that were comfortable for the user. The surface area of the electrodes (a design later incorporated into INNOVO) is more comfortable than vaginal probe therapy because the current is spread over a very large area and it’s 100% non-invasive.

INNOVO is a wearable device (it’s a pair of bike shorts) that delivers 180 perfect Kegels per session and strengthens your pelvic floor from home. It’s also super simple to use - you just slip on the shorts and turn on the controller! Use INNOVO for 30 minutes a day, five days a week, and be one of the 87% of women that are leak-free in 12 weeks or less. Plus, 80% of women see results in just 4 weeks.