Pelvic health physiotherapy · UK
Electrical stimulation of the pelvic floor, alongside proper physiotherapy.
Neuromuscular electrical stimulation delivered by a POGP-registered pelvic health physiotherapist — as an adjunct to supervised pelvic floor muscle training, positioned exactly where NICE NG123 places it.
Why patients choose us
- 01
A specialist pelvic health physio, first
A POGP-registered pelvic health physiotherapist leads the assessment — electrical stimulation is added when it earns its place, not because a device is for sale.
- 02
NICE-aligned care
Pelvic floor muscle training is first line under NICE NG123. E-stim is an adjunct — for women who cannot voluntarily contract, or after a supervised three-month PFMT trial has fallen short.
- 03
Independent, and free
We are paid by no clinic and by no device maker, so the plan you get is impartial and costs you nothing.
Indicative pricing
What a private course of pelvic floor e-stim costs in the UK.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options.
In short
A supervised eight-week programme in our network: £600–£1,100, home unit from £140.
| Service or device | Indicative range | Typical duration | Course |
|---|---|---|---|
| Pelvic health physio — initial assessment | £140–£220 | 45–60 min | Same visit |
| Clinic-based e-stim session | £70–£120 | 30 min | Same visit |
| Eight-week supervised programme | £600–£1,100 | 2×/week | 8 weeks |
| Home unit (Kegel8 Ultra 20 / Elise2) | £140–£280 | One-off | Own device |
| Neurotrac PelviTone / MyoPlus (biofeedback) | £280–£520 | One-off | Own device |
| Follow-up review | £90–£140 | 30 min | Same visit |
Prices vary by clinic, by the individual physiotherapist, and by whether you use a clinic-based programme, a home unit, or a mix of the two. We come back with a firm quote within one working day.
The problem
The right physio, the right protocol, the right escalation.
Pelvic floor e-stim gets sold as a shortcut. It is not. Used well, it earns its place as an adjunct to PFMT — and if a fair trial has not worked, the next step is a different treatment, not a longer course.
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Buying a device blind?
A physio assessment first tells you whether e-stim is likely to help — and which programme, which route, which frequency.
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PFMT not working alone?
NICE says try three months of supervised PFMT. If it has not worked well enough, e-stim as an adjunct is the next step, not surgery.
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Cannot feel the contraction?
An Oxford 0–1 grade is exactly when e-stim earns its place — it recruits the muscle so PFMT starts to work.
The journey
From enquiry to review — what happens, in order.
One physiotherapist from first message to end-of-course review — and an honest escalation plan if the programme has not been enough.
Phase 1 · Before your programme
Concierge, off-stage for you
Phase 2 · Starting the course
First sessions with the physio
Phase 3 · Ongoing
Home use and review
- 01
Before
You tell us what is going on
A short, confidential form. Symptoms — stress leaks, urgency, mixed, faecal — how long, and what you have already tried.
- 02
Before
We come back with a recommendation
Within one working day: which pelvic health physiotherapist to see, whether e-stim is likely to help, and an indicative price.
- 03
Before
We arrange the assessment
Usually within one to two weeks. Digital vaginal or rectal examination, muscle grading (Oxford scale), and a plan agreed with you.
- 04
Starting
Your first session
Electrode fitted — vaginal, rectal or surface. Current is titrated to a strong but comfortable contraction. Twenty minutes, in private.
- 05
Starting
Home programme set up
If a home unit suits you, the physio programmes it — Kegel8, Elise2 or Neurotrac — and shows you exactly how to use it.
- 06
After
Two to three sessions a week
Twenty-minute sessions, at home or in clinic, alongside daily pelvic floor muscle training. A course runs eight to twelve weeks.
- 07
After
Review and next steps
Symptom diary reviewed. If leaks have not improved enough, PTNS, sacral neuromodulation or a urogynaecology referral are considered.
Typical end-to-end: 1–2 weeks from enquiry to first session. Full course: 8–12 weeks.
When it helps
When pelvic floor e-stim is the right adjunct.
The situations where NICE and the pelvic health physiotherapy community put e-stim on the table — and the one line that tells you it is being oversold.
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Stress urinary incontinence
Leaks with cough, sneeze, laugh or exercise — where PFMT alone has not been enough after a three-month supervised trial.
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Overactive bladder / urge
Sudden urgency, frequency, nocturia. Low-frequency stimulation (5–10Hz) targets detrusor overactivity via the pudendal reflex.
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Cannot voluntarily contract
When a digital assessment shows a very weak or absent contraction (Oxford 0–1), e-stim is offered from the start per NICE NG123.
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Postnatal pelvic floor weakness
After a vaginal birth, tear or instrumental delivery — added when PFMT progress stalls. MASIC supports women after severe tears.
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Faecal incontinence
Passive soiling or urgency of stool — anal e-stim with biofeedback is an established option before considering sacral neuromodulation.
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Male LUTS after prostate surgery
Post-prostatectomy stress incontinence in men — supervised PFMT plus e-stim aligns with NICE NG12 pathways.
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Perimenopause and beyond
Weakening pelvic floor with age or oestrogen decline. Vaginal atrophy should be treated first before intravaginal probes are used.
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Red flag: not a first-line device
E-stim is an adjunct, not a substitute for pelvic floor muscle training. Anyone selling it as a standalone cure is overselling it.
Options
E-stim is not one thing — and PTNS and sacral neuromodulation are different treatments.
What each route actually involves — and how it sits next to the neuromodulation options for patients who need more.
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Vaginal probe stimulation
The commonest route for women. A small intravaginal electrode delivers biphasic pulsed current at 20–50Hz for stress leaks, 5–10Hz for urgency.
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Rectal probe stimulation
Used for faecal incontinence and in men — same waveform principles, delivered via an anal electrode by the physiotherapist.
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Surface (external) electrodes
Pads placed over the perineum or sacrum for patients who cannot tolerate an internal probe. Less targeted, but a real option.
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Home NMES units
Kegel8 Ultra 20, Elise2, Neurotrac PelviTone — CE-marked home units programmed by the physio for daily use between clinic reviews.
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Biofeedback plus e-stim
A dual-channel unit shows the muscle working in real time — the strongest evidence when combined with supervised pelvic floor muscle training.
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PTNS (posterior tibial nerve)
A separate technique — a fine needle at the ankle stimulates the tibial nerve for overactive bladder. Weekly for twelve weeks. Mentioned briefly; a distinct pathway.
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Sacral neuromodulation
A different treatment altogether — an implanted device for refractory urge and faecal incontinence, delivered by a urogynaecologist or colorectal surgeon.
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Assessment only
An honest pelvic floor assessment to work out whether e-stim, PFMT alone, or a specialist referral is the right step. No obligation.
Our vetted UK network
A small panel of pelvic health physios, we picked them.
POGP-registered pelvic health physiotherapists across the UK. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every physiotherapist in our network.
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POGP-registered pelvic health physiotherapists, not general MSK physios
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Vaginal, rectal and surface options — the right route for the patient
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CE-marked devices only (Kegel8, Elise2, Neurotrac and equivalents)
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Onward pathway to urogynaecology, PTNS or sacral neuromodulation when e-stim has not been enough
Safety and evidence
What to expect — honestly.
Pelvic floor e-stim is safe and well tolerated when the contraindications are respected. The evidence base is moderate — strongest as an adjunct to PFMT, weaker as a standalone treatment.
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Not in pregnancy
Intravaginal or intrapelvic e-stim is not used during pregnancy. Postnatal, we usually wait until after the six-week check.
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Not with a pacemaker or ICD
Any implanted cardiac device is a contraindication. Tell the physio at the assessment — this is a hard stop.
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Not with active pelvic infection
Current UTI, vaginal or pelvic infection — treat first, then start. Malignancy in the treatment field is a contraindication.
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Epilepsy needs a specialist view
Poorly controlled epilepsy is a relative contraindication. Neurology input is arranged before starting.
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Atrophic vaginitis — treat first
Vaginal dryness or atrophy makes a probe uncomfortable and can cause bleeding. Topical oestrogen is usually started before intravaginal e-stim.
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Sensation, not pain
The current should feel like a strong but comfortable contraction — never sharp or painful. Amplitude is titrated by you, in the room.
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Evidence is moderate, not miraculous
The best evidence for e-stim is as an adjunct to pelvic floor muscle training. As a monotherapy the evidence is weaker — we say so.
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A twelve-week fair trial
Give the programme a proper eight-to-twelve weeks before deciding it has not worked. Symptom diaries make the difference visible.
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Red flags
Bleeding, new pelvic pain, worsening incontinence or urinary retention are reasons to stop and be reviewed the same week.
Reading your physio notes
Your physio notes in four parts. Read the last one first.
Whichever route was used, the treatment note your pelvic health physiotherapist writes keeps to the same shape.
A quiet reminder
Physiotherapy notes are technical — we translate them for you.
If you would like us to talk you through the notes before your review, just ask.
- 01 Header
Diagnosis and Oxford grading
The type of incontinence (stress, urge, mixed, faecal) and your baseline pelvic floor muscle strength on the modified Oxford scale (0–5).
- 02 Technique
Electrode, waveform and protocol
Vaginal, rectal or surface; the frequency (Hz), pulse width, on/off ratio and session length — so any physio can pick up where the last left off.
- 03 Findings
Response, tolerance and home settings
How you tolerated the current, whether biofeedback was used, and the exact home unit programme — Kegel8, Elise2 or Neurotrac preset numbers.
- 04 Impression
Next steps and onward referral
Read this first: whether to continue, escalate to PTNS or sacral neuromodulation, or refer to urogynaecology. And the review date.
Recognised by major UK insurers
Cover for pelvic health physiotherapy varies by insurer and by indication — often funded when medically indicated, sometimes a limited number of sessions. We confirm cover before booking.
Frequently asked
Everything we get asked about pelvic floor e-stim.
Quick answers on NICE positioning, protocols, home units, contraindications and what to try next.
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What is electrical stimulation of the pelvic floor?
A pelvic health physiotherapist delivers a small, painless electrical current — via a vaginal probe, rectal probe or surface electrode — to make the pelvic floor muscles contract. It is used alongside pelvic floor muscle training (PFMT) for urinary incontinence, faecal incontinence and pelvic floor weakness.
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Does NICE recommend pelvic floor e-stim?
NICE NG123 (urinary incontinence and pelvic organ prolapse in women) places supervised pelvic floor muscle training as first line for at least three months. Electrical stimulation is offered as an adjunct when a woman cannot voluntarily contract her pelvic floor, or when a supervised PFMT trial has not worked well enough. NG12 covers men with lower urinary tract symptoms; CG49 covers faecal incontinence.
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How does it actually work?
A biphasic pulsed current stimulates the pudendal nerve (and its S2–S4 sacral roots), which either contracts the external urethral and anal sphincters — 20–50Hz for stress incontinence — or inhibits the detrusor muscle via a reflex — 5–10Hz for urge incontinence and overactive bladder.
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How long is a course, and how often?
Twenty-minute sessions, two or three times a week, for eight to twelve weeks. Some women do all of it at home with a programmed unit; others prefer a mix of clinic sessions and home use, reviewed every few weeks.
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Home unit or clinic sessions — which is better?
For most people a home unit (Kegel8 Ultra 20, Elise2 or Neurotrac PelviTone) after a proper physio assessment is enough. Clinic sessions are useful when the muscle is very weak, biofeedback is needed, or when starting a rectal protocol for faecal incontinence.
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Does it hurt?
No. It should feel like a strong but comfortable pull as the muscle contracts. You control the amplitude in the room. Any sharp, burning or painful sensation is a signal to stop and adjust.
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Who should not have pelvic floor e-stim?
It is not used in pregnancy, in anyone with a pacemaker or implantable cardiac device, during active pelvic or urinary infection, over malignancy in the treatment field, or in poorly controlled epilepsy without neurology input. Atrophic vaginitis should be treated with topical oestrogen before intravaginal probes.
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What if e-stim does not fix it?
The next steps under NICE are separate treatments — percutaneous tibial nerve stimulation (PTNS) or sacral neuromodulation for refractory overactive bladder and faecal incontinence, or urogynaecology assessment for surgery. We refer on rather than repeat a course that has not worked.
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Where can I find UK support?
Bladder & Bowel UK, the Pelvic, Obstetric and Gynaecological Physiotherapy network (POGP) and the MASIC Foundation (for women after severe perineal tears) are the three UK charities and professional bodies we most often signpost.
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How much does it cost privately?
A specialist pelvic health physio assessment is £140–£220. Clinic-based e-stim sessions are £70–£120 each. An eight-week supervised programme sits between £600 and £1,100. Home units cost £140–£520 depending on model. We confirm a firm figure within one working day.