Does Emsella Work for Urinary Incontinence?
Possibly, but the evidence is early. In the largest study sourced here (75 women, no control group), incontinence symptom scores roughly halved after six sessions. A small randomized trial found that adding Emsella to pelvic floor exercises improved muscle strength more than exercises alone. A 2025 systematic review rated the certainty of the evidence low to very low. Results vary; consult a qualified provider.
What is Emsella?
Emsella is a chair made by BTL. The patient sits on it while a high-intensity focused electromagnetic field (the same HIFEM (High-Intensity Focused Electromagnetic Field) principle used in Emsculpt for the body) stimulates the pelvic floor muscles; the FDA summary for the device describes the stimulation as entirely non-invasive. In the main US study, a course was six 28-minute sessions over about three weeks (two per week), with intensity set as high as the patient could tolerate. See HIFEM Muscle Stimulation Explained for the wider device family.
What does the evidence show?
- Samuels et al. 2019 (75 women, four US practices, no control group). Women with stress, urge, or mixed incontinence were treated six times. On the ICIQ-SF questionnaire (a 0–21 symptom score, lower is better), the average fell from 10.6 to 5.3 after the sixth session and 4.2 at three months. Daily pad use fell from about 2.5 to 1.35 after session six and 1.2 at three months. About 81% said symptoms were significantly reduced. Because there was no control or sham group, some of this improvement may reflect placebo effects or natural fluctuation, and the numbers shrink as people drop out of the analysis (75 enrolled, 61 in the questionnaire analysis, 43 in the pad analysis, with no explanation).
- Elgayar 2024 (randomized, 43 postmenopausal women analyzed). All women did supervised pelvic floor exercises for 12 weeks; half also had 24 Emsella sessions. The Emsella group gained more pelvic floor strength (about 19.7 to 29.7 vs 19.8 to 25.1) and endurance, and scored better on a sexual function questionnaire. This was not an incontinence trial: women had pelvic floor weakness and sexual dysfunction, and no incontinence outcome was reported. There was no sham arm, and participants knew which group they were in.
- Sacarin et al. 2025 (systematic review, 5 studies, about 219 women). The review pooled small studies of chair-based magnetic stimulation, mixing Emsella-type devices with other magnetic chairs. It rated the evidence as low-certainty for incontinence scores and very low for sexual function, found all three non-randomized studies at “serious” risk of bias, and noted that none of the included studies reported adverse events in a usable way. It could not combine the results statistically.
Is there sham-controlled evidence?
Several sham-controlled Emsella trials are registered (for stress incontinence, overactive bladder, and others), but this site has not found published results for them and does not cite them. Until they are sourced, the best-controlled data for the HIFEM chair is the add-on trial above.
Is Emsella safe?
The 2019 study reported no treatment-related adverse events, with some muscle fatigue, and no pain or downtime. The Elgayar trial reported none either. But the systematic review points out that adverse-event reporting in this literature is thin, so small studies can’t establish rare risks. Contraindications specific to Emsella were not sourced. The trial excluded women with metal implants, pelvic tumors, and prolapse, among others; ask a provider about pacemakers, implants, pregnancy, and your own conditions.
Is it FDA-cleared?
The best match found is FDA 510(k) K162010 (December 2016), for a BTL device named HPM-6000U. It is cleared for electromagnetic stimulation of pelvic floor muscles to treat urinary incontinence in women, based on similarity to an earlier device. The brand-to-clearance match is an inference (the FDA document doesn’t use the word “Emsella”). This site found no FDA record for uses such as male incontinence or sexual function, so claims about those should be treated as unverified. Clearance is not proof that a treatment works.
How much does it cost?
No pricing was sourced for this page, and none is given here.
What’s still missing from the evidence
- Published sham-controlled results for incontinence (several trials are registered).
- Head-to-head comparison with pelvic floor physical therapy alone for incontinence outcomes, or with other treatments.
- Follow-up beyond about three months in the main study (the authors themselves call for 6–12 months).
- Usable adverse-event reporting.
- Evidence for men, postpartum use, and other uses marketed for the chair.
FAQ
How many Emsella sessions are needed? The 2019 US study used six sessions over about three weeks; the Egyptian trial used 24 over 12 weeks alongside exercises. No standard schedule is established.
Is Emsella better than Kegel exercises? Not shown. The one controlled trial found that adding Emsella to pelvic floor training improved strength more than training alone; it didn’t compare Emsella alone against exercises, and it didn’t measure incontinence.
Does Emsella help sexual function? One randomized trial in postmenopausal women found larger gains in a sexual function score when Emsella was added to exercises, but the trial was small and unblinded, and the systematic review rated the evidence very low certainty.
Does it work for men? This site has not sourced evidence or an FDA clearance for male incontinence.
How long do results last? Unknown beyond about three months in the main study.
This page is educational, not medical advice. Results vary; consult a qualified, licensed provider.
Sources
Samuels JB, Pezzella A, Berenholz J, Alinsod R. “Safety and Efficacy of a Non-Invasive High-Intensity Focused Electromagnetic Field (HIFEM) Device for Treatment of Urinary Incontinence and Enhancement of Quality of Life.” Lasers in Surgery and Medicine 51(9):760–766, 2019. doi:10.1002/lsm.23106. ⚠️ Open-label, single-arm.
Elgayar SL. “Combined effects of high-intensity focused electromagnetic therapy and pelvic floor exercises on pelvic floor muscles and sexual function in postmenopausal women.” Obstetrics & Gynecology Science 67(6):574–585, 2024. doi:10.5468/ogs.24103.
Sacarin G, Craina M, Sorop B, et al. “Chair-Based Magnetic Pelvic Floor Stimulation and Female Sexual Function in Women with Urinary Incontinence: A Systematic Review.” Journal of Clinical Medicine 14(23):8496, 2025. doi:10.3390/jcm14238496.
FDA 510(k) Premarket Notification K162010 (BTL HPM-6000U), December 13, 2016. ⚠️ Best-inferred match for Emsella, not FDA-confirmed by brand name.
Selection notes on studies considered and excluded.