Abstract
Simultaneous electromyographic (EMG) recordings with intramuscular wire electrodes from the left and right pubococcygeal muscles were performed to elucidate the neurophysiological effect of vaginal cones on the pelvic floor muscles. Ten continent nulliparous women (aged 22–32 years) and 20 stress urinary incontinent parous women (aged 27–60 years, average 2–4 deliveries) were examined before, during holding and after removal of the cone. All the continent nulliparous women could retain the cone in the vagina (mean weight 83.5 g (range 70–85 g). In the incontinent parous group 7 women could not hold any cone, 9 women could hold the 45 g cone, 1 the 32.5 g cone and 3 women the 57.5g cone. There was a significant voluntary holding time difference between continent nulliparous and incontinent parous women. The study reveals that vaginal cones may induce both strengthening of muscles as well as a learning effect leading towards a better coordinated muscle activation.
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Editorial Comment. This paper gives more clarification as to the (good) effect of vaginal cones. Even though Plevnik and co-authors suspected some kind of reflex activity in 1985, this study demonstrates nicely the electromyographic effects, including intermittent activation as well as possible recruitment of motor units even in previously unilateral inhibited motor units. A prerequisite of this treatment is good compliance and the ability to retain the cones, which was impossible in 7 out of 20 women.
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Deindl, F.M., Schüssler, B., Vodusek, D.B. et al. Neurophysiologic effect of vaginal cone application in continent and urinary stress incontinent women. Int Urogynecol J 6, 204–208 (1995). https://doi.org/10.1007/BF01894264
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DOI: https://doi.org/10.1007/BF01894264