Four, honestly stated. It is a course of six sessions over three weeks, not a single visit. The result eases after six to twelve months in our experience, so it needs a top-up to hold. It does not fix an overactive bladder on its own and it does not put a prolapse back. And the evidence behind it is small, mostly from studies with no comparison group, with the larger sham-controlled trials still recruiting. None of these is a reason not to have it for stress or mixed leaks; all of them are reasons to know what you are buying. The clinician tells you at the free consultation which applies to you.
It is a course, and you have to turn up
Six sessions of 28 minutes, twice a week, over three weeks: the protocol of the published studies and of the clinic. A single session shows you what it feels like, not what it does. The sessions page explains why six.
The result is not for ever
Results build for three months after the sixth session and then ease. In our experience the result holds around six to twelve months, and a single top-up session every six months or so tends to maintain it. The studies follow people for three to nine months, no longer, so anything beyond that is the clinic's experience rather than a measurement. The how long it lasts page gives the timeline.
It does not fix everything that leaks
Emsella is FDA-cleared in the US for urinary incontinence. Stress leaks, the kind that come with a cough, a sneeze or a run, and mixed leaks respond best. In the main study, symptom scores improved by 67% for stress and 70% for mixed incontinence at three months, against 27% for urge-only leaks after the sixth session and 54% at three months. It does not fix an overactive bladder on its own, it does not put a prolapsed organ back, and it is not for overflow incontinence or a neurological bladder. If your leaks are mostly urge, the clinician says so and sets out what else is needed.
The evidence is small
The main study, 75 women, had no comparison group; the leak questionnaire score fell from 10.6 to 4.2 in the 61 women assessed at three months. A 2024 study of 35 women found scores 60% lower at one month. Sham-controlled trials are registered and some are recruiting. The US regulator's summary lists the side effects: muscular pain, temporary muscle spasm, temporary joint or tendon pain, a temporary increase in local circulation, increased sensitivity during intercourse, skin redness. In the clinic's experience some people feel muscle fatigue or mild soreness for a day, as after exercise. Because the evidence is small, in our practice the ICIQ-SF leak questionnaire is scored at the consultation, at the end of the course and at six months, and if the score has not moved, we say so. The does it work page goes through the studies.
Who cannot sit on it
A pacemaker, defibrillator or any implanted electronics; metal implants in the pelvis, including a hip replacement; a copper coil. Some hormonal coils carry a small silver ring, so the clinic checks the maker's guidance. Also pregnancy or planning one, the first three months after a birth, healing pelvic or abdominal surgery, untreated cancer, and under 18. Whether to treat during a period is the clinician's call.
What is not a downside
You stay clothed, nothing goes inside you, there was no downtime reported in the main study, and in the clinic's experience you walk out, drive, work and exercise as normal. It is not on the NHS pathway, and NICE's first-line advice is supervised pelvic floor training for at least three months; the chair works alongside that, not instead of it. Emsella is priced per session and per course, confirmed in writing at your free consultation, with a price match on any comparable written quote.
Book a free consultation
Call Emsella Clinic on 0207 099 9659 or use the form below. The clinician tells you which of these downsides applies to your symptoms and sets out the course and the review in writing. Our patients review the clinic on review.clinic, where it scores 4.9 out of 5 from 107 reviews in November 2026.
