Imaging and molecular mechanisms of pelvic floor electrical stimulation in improving pelvic floor muscle injury in stress urinary incontinence rats

Moris L, Heesakkers J, Nitti V, O’Connell HE, Peyronnet B, Serati M, Omar MI, Harding C (2025) Prevalence, diagnosis, and management of stress urinary incontinence in women: a collaborative review. Eur Urol 2025:292–301. https://doi.org/10.1016/j.eururo.2024.12.017

Article  Google Scholar 

Wang C, Wei W, Ma D, Huimin Y, Lingzhi Y (2025) Prevalence and determinants of stress urinary incontinence in middle-aged and older women: a systematic review and meta-analysis. Arch Esp Urol 2025:46–55. https://doi.org/10.56434/j.arch.esp.urol.20257801.6

Article  Google Scholar 

Huang H, Ding G, Mei Li Y, Deng YC, Jin H (2023) Menopause and stress urinary incontinence: the risk factors of stress urinary incontinence in perimenopausal and postmenopausal women. J Obstet Gynaecol Res 2023:2509–2518. https://doi.org/10.1111/jog.15742

Article  Google Scholar 

Pang H, Lv J, Xu T, Li Z, Gong J, Liu Q, Wang Y, Wang J, Xia Z, Li Z, Li L, Zhu L (2022) Incidence and risk factors of female urinary incontinence: a 4-year longitudinal study among 24985 adult women in China. BJOG 2022:580–589. https://doi.org/10.1111/1471-0528.16936

Article  Google Scholar 

de Vries AM, Venema PL, Heesakkers JPFA (2018) Midurethral support is also necessary for reflex closure of the urethra. Neurourol Urodyn 2018:2965–2972. https://doi.org/10.1002/nau.23807

Article  Google Scholar 

Wu JM (2021) Stress incontinence in women. N Engl J Med. https://doi.org/10.1056/NEJMcp1914037

Article  PubMed  PubMed Central  Google Scholar 

Sheng Y, Liu X, Low LK, Ashton-Miller JA, Miller JM (2020) Association of pubovisceral muscle tear with functional capacity of urethral closure: evaluating maternal recovery from labor and delivery. Am J Obstet Gynecol 2020:591–598. https://doi.org/10.1016/j.ajog.2019.11.1257

Article  Google Scholar 

Del Vescovo R, Piccolo CL, Vecchia ND, Giurazza F, Cazzato RL, Grasso RF, Zobel BB (2014) MRI role in morphological and functional assessment of the levator ani muscle: use in patients affected by stress urinary incontinence (SUI) before and after pelvic floor rehabilitation. Eur J Radiol 2014:479–486. https://doi.org/10.1016/j.ejrad.2013.11.021

Article  Google Scholar 

Dierick F, Galtsova E, Lauer C, Buisseret F, Bouché A-F, Martin L (2018) Clinical and MRI changes of puborectalis and iliococcygeus after a short period of intensive pelvic floor muscles training with or without instrumentation : a prospective randomized controlled trial. Eur J Appl Physiol 2018:1661–1671. https://doi.org/10.1007/s00421-018-3899-7

Article  Google Scholar 

Nio FIA, Kari B, Pena CC, Bueno SM, Mateus-Vasconcelos ECL, Fernandes ACNL, Ferreira CHJ (2022) Intravaginal electrical stimulation increases voluntarily pelvic floor muscle contractions in women who are unable to voluntarily contract their pelvic floor muscles: a randomised trial. J Physiother 2022:37–42. https://doi.org/10.1016/j.jphys.2021.12.004

Article  Google Scholar 

Fang W, Xuan D, Yang R, Liu M, Yang M, Jin Y, Gao G, Qiang F, Wang Y (2025) Injectable therapeutic system incorporating neurogenesis-programmed stem cells concomitantly promoting muscle regeneration treats stress urinary incontinence. Nat Commun 2025:8404. https://doi.org/10.1038/s41467-025-63421-2

Article  CAS  Google Scholar 

Franco GR, De Oliveira E, Baracat EC, De Jesus M, Es S, Sartoria MGF, Manuel JO, Batista Gir O, Castro RA (2011) Histomorphometric analysis of a rat bladder after electrical stimulation. Rev Assoc Med Bras (1992) 57:20–24

Article  PubMed  Google Scholar 

Li Y, Liu C, Li B, Hong S, Min J, Hu M, Tang J, Wang T, Yang L, Hong L (2019) Electrical stimulation activates calpain 2 and subsequently upregulates collagens via the integrin β1/TGF-β1 signaling pathway. Cell Signal. https://doi.org/10.1016/j.cellsig.2019.03.023

Article  PubMed  PubMed Central  Google Scholar 

Sheth VR, Duran P, Wong J, Shah S, Du J, Christman KL, Chang EY, Alperin M (2019) Multimodal imaging assessment and histologic correlation of the female rat pelvic floor muscles’ anatomy. J Anat. https://doi.org/10.1111/joa.12943

Article  PubMed  PubMed Central  Google Scholar 

Li C, Long B, Deng H, Sun H, Liao L, Li X (2025) Implantable electrical stimulation device enhances pelvic floor tissue repair and reduces collagen over-degradation in rats with stress urinary incontinence. Sci Rep. https://doi.org/10.1038/s41598-025-16162-7

Article  PubMed  PubMed Central  Google Scholar 

Jiang H-H, Song Q-X, Gill BC, Balog BM, Juarez R, Cruz Y, Damaser MS (2018) Electrical stimulation of the pudendal nerve promotes neuroregeneration and functional recovery from stress urinary incontinence in a rat model. Am J Physiol Renal Physiol. https://doi.org/10.1152/ajprenal.00431.2017

Article  PubMed  PubMed Central  Google Scholar 

Hijaz A, Daneshgari F, Sievert K-D, Damaser MS (2008) Animal models of female stress urinary incontinence. J Urol 2008:2103–2110. https://doi.org/10.1016/j.juro.2008.01.096

Article  Google Scholar 

Li N, Cui C, Cheng Y, Yanhong W, Yin J, Shen W (2018) Association between Magnetic Resonance Imaging Findings of the Pelvic Floor and de novo Stress Urinary Incontinence after Vaginal Delivery. Korean J Radiol 2018:715–723. https://doi.org/10.3348/kjr.2018.19.4.715

Article  Google Scholar 

Lin AS, Carrier S, Morgan DM, Lue TF (1998) Effect of simulated birth trauma on the urinary continence mechanism in the rat. Urology. https://doi.org/10.1016/s0090-4295(98)00136-8

Article  PubMed  Google Scholar 

Damaser MS, Whitbeck C, Chichester P, Levin RM (2005) Effect of vaginal distension on blood flow and hypoxia of urogenital organs of the female rat. J Appl Physiol. https://doi.org/10.1152/japplphysiol.01071.2004

Article  PubMed  Google Scholar 

Huang X, Zhou M, Wang Y, Chen M, Xiao Y, Li L, Zhu F, Chen L, Tian X, Shiman W, Li B, Hong L (2026) Estrogen deficiency induces pelvic floor muscle atrophy via ERα/GLUT4 pathway. PLoS ONE 2026:e349371. https://doi.org/10.1371/journal.pone.0349371

Article  CAS  Google Scholar 

Ponnusamy S, Sullivan RD, Thiyagarajan T, Tillmann H, Getzenberg RH, Narayanan R (2017) Tissue selective androgen receptor modulators (SARMs) increase pelvic floor muscle mass in ovariectomized mice. J Cell Biochem 2017:640–646. https://doi.org/10.1002/jcb.25751

Article  CAS  Google Scholar 

Wu C, Zheng X, Li Q, Chen Y, Liu W, Song X, Han Q, Zhang Q, Fu C, Mei Q, Liu X, Xu J, Zhou J, Wu T (2025) Atrophy masseter recovery by electrical stimulation mediated M2-like macrophage polarisation via JAK/PI3K/AKT pathway. J Cachexia Sarcopenia Muscle. https://doi.org/10.1002/jcsm.70048

Article  PubMed  PubMed Central  Google Scholar 

Abe-Takahashi Y, Kitta T, Ouchi M, Chiba H, Higuchi M, Togo M, Kusakabe N, Kakizaki H, Shinohara N (2024) Morphological examination of pelvic floor muscles in a rat model of vaginal delivery. BMC Pregnancy Childbirth. https://doi.org/10.1186/s12884-024-06278-5

Article  PubMed  PubMed Central  Google Scholar 

Yang S-J, Wang J, Jie X, Bai Y, Guo Z-J (2018) miR-93-mediated collagen expression in stress urinary incontinence via calpain-2. Mol Med Rep 2018:624–629. https://doi.org/10.3892/mmr.2017.7910

Article  CAS  Google Scholar 

Rechberger T, Postawski K, Jakowicki JA, Gunja-Smith Z, Woessner JF Jr (1998) Role of fascial collagen in stress urinary incontinence. Am J Obstet Gynecol. https://doi.org/10.1016/s0002-9378(98)70017-1

Article  PubMed  Google Scholar 

Han L, Wang L, Wang Q, Li H, Zang H (2014) Association between pelvic organ prolapse and stress urinary incontinence with collagen. Exp Ther Med. https://doi.org/10.3892/etm.2014.1563

Article  PubMed  PubMed Central  Google Scholar 

Li C, Yang M, Zhiyu Q, Ruan S, Chen B, Ran J, Shu W, Chen Y, Hou W (2022) Effect of electroacupuncture on the degradation of collagen in pelvic floor supporting tissue of stress urinary incontinence rats. Int Urogynecol J 2022:2233–2240. https://doi.org/10.1007/s00192-022-05106-8

Article  Google Scholar 

Min J, Li B, Liu C, Hong S, Tang J, Hu M, Liu Y, Li S, Hong L (2017) Therapeutic effect and mechanism of electrical stimulation in female stress urinary incontinence. Urology. https://doi.org/10.1016/j.urology.2017.02.005

Article  PubMed  PubMed Central  Google Scholar 

Stania M, Niemiec B, Kamieniarz A, Chmielewska D (2022) Intravaginal electrical stimulation as a monotherapy for female stress urinary incontinence: a systematic review and meta-analysis. Complement Ther Clin Pract 2022:101624. https://doi.org/10.1016/j.ctcp.2022.101624

Article  Google Scholar 

Fürst MCB, De Mendon RRA, Rodrigues AO, De Matos LL, Pompeo ANCL, Bezerra CA (2014) Long-term results of a clinical trial comparing isolated vaginal stimulation with combined treatment for women with stress incontinence. Einstein (Sao Paulo). https://doi.org/10.1590/s1679-45082014ao2866

Article  PubMed  PubMed Central 

Comments (0)

No login
gif