What does the Emsella chair do?
It is a chair with a coil in the seat that delivers high-intensity focused electromagnetic energy (HIFEM) to the pelvic floor muscles. The field makes the muscles contract without you tightening them. In one trial protocol that came to about 11,000 contractions in a 28-minute session, which is why the treatment is described as muscle training done for you. How Emsella works, and which leakage it can help covers the mechanism and the types of leakage; this page is about risk and the first visit.
What do the trials show, and what are their limits?
The early evidence is encouraging and uncontrolled. In a 2019 study of 75 women, Samuels and colleagues gave six 28-minute sessions over three weeks. Afterwards 61 of 75 reported a significant reduction in symptoms, the ICIQ-SF incontinence score improved by about 50%, rising to about 64% at three months, and pad use fell by about 44% and then 54%. There was no control group, so some of that improvement may come from expectation and the natural course of symptoms.
Controlled evidence is smaller and more cautious. A 2026 pilot of 40 women compared HIFEM plus pelvic floor training with sham HIFEM plus training, weekly for six weeks. It found no significant difference between the groups on any outcome; pad-test leakage improved within the HIFEM group (p = 0.049), while symptom scores improved in both. It was a feasibility pilot, and its authors ask for a larger trial. A 2026 randomised trial of 44 women gave everyone supervised pelvic floor training, with HIFEM added in one arm. After correcting for multiple comparisons, the HIFEM arm improved more on peak muscle activity, maximum voluntary contraction and one symptom score; the other measures did not hold up, and there was no HIFEM-only arm.
In men, a 27-man retrospective study after prostate surgery reported the incontinence score falling from 10.58 to 5.43 after six sessions and 4.16 a month later, with no control group. Taken together, the fair summary is that the chair is promising as an addition to exercise, that benefit as a stand-alone treatment is not settled, and that long-term follow-up is thin.
What are the side effects of Emsella?
Few have been reported. The 75-woman study recorded no pain, downtime or adverse events. The 27-man study reported only mild, transient muscle discomfort and no major adverse effects. The 99-woman comparison reported no treatment-related adverse events, and the 44-woman trial had the intensity raised to the maximum each person tolerated.
Read those results with their limits in mind. The studies are small, last weeks to months, and enrolled people after screening out the groups described below, so they describe screened people and do not prove that no one is affected. Muscle soreness or fatigue after a session is a reasonable thing to ask about, and any sharp pain, new bleeding or a change in urinary pattern is a reason to stop and be assessed.
Who should not have Emsella?
The trials give a consistent list of exclusions. A cardiac pacemaker or implanted defibrillator, a metal implant such as spinal cord hardware, and other implants contraindicated for magnetic fields. An untreated cardiac arrhythmia. Vaginal or pelvic surgery in the last six months, childbirth in the last 12 weeks or a miscarriage in the last six, and any recent surgery. An active urinary or genital infection, blood in the urine of unknown cause, or an untreated blockage to bladder outflow. Pelvic cancer or pelvic radiotherapy in the last six months. Neurological or neuromuscular disease, or kidney or liver failure. Prolapse of stage II or above, and fever.
Two cautions on that list. These are exclusion criteria from published trials, not the manufacturer's own contraindications, although one trial also excluded anything the device manual lists. The manual governs, and a clinic should be able to show it. And this clinic's screening also excludes pregnancy, even though the trials above, which enrolled women who were not pregnant, do not discuss it.
What is the first session like?
It starts with an assessment of the type of leakage, because the chair suits some patterns and not others. At the session you sit upright on the chair fully clothed, with staff positioning you so the field lines up with the pelvic floor. There is no probe and no preparation, and the session lasts about 28 to 30 minutes with no recovery time.
The sensation is the muscle contracting in rhythm. In the trial protocols the intensity was raised gradually to the maximum the person tolerated, so you are part of setting the level and can say when it is too strong. Mention any implant, device or recent surgery before the chair is switched on.
How many sessions do studies use?
Most used six sessions of 28 minutes, twice a week over three weeks. The 44-woman trial used twelve sessions, twice weekly for six weeks, and the sham-controlled pilot used six weekly sessions. At this clinic a course is usually six sessions over about three weeks, confirmed at assessment and reviewed against how symptoms respond. No study read shows how long the effect lasts beyond a few months, so no duration is promised.
When should I see a urogynaecologist or physiotherapist first?
See a doctor first for leakage with pain, blood, fever or a sudden change in pattern, and for a bulge or heaviness that suggests prolapse. In a comparison of 133 menopausal women with grade 2 prolapse and leakage, surgery corrected the prolapse more often than the chair (88% against 64% reaching stage 0) and recurred less at one year (14% against 31%), while the chair allowed a faster recovery, with 91% back to daily activities within a week. Prolapse beyond a mild degree belongs with a urogynaecologist first.
Supervised pelvic floor muscle training, usually led by a physiotherapist, is the usual first-line treatment for stress incontinence, and the chair can sit beside it. In the 99-woman study, adding a structured Kegel programme to Emsella gave better scores than Emsella alone. Leaking urine after childbirth sets out the exercises and when each route is right, and the bladder leakage page maps the types. Emsella is offered at this clinic, and Dr Ong sees the patients; the Emsella page explains the treatment and the assessment that comes first.
