The Emsella chair in London: does it work, cost, sessions and who it suits

This guide is written by the team that runs Emsella at our clinic in the Harley Street medical district and reviewed by our clinician. It explains how the chair works, what the studies measured, what a course involves and what you may feel, how we price it, how it fits with pelvic floor exercises and who it suits best, so you arrive at your free consultation knowing what to ask.

What Emsella is

Emsella is a treatment chair made by BTL Industries. A coil in the seat produces a pulsed magnetic field, which BTL calls HIFEM, high-intensity focused electromagnetic energy. The field passes through clothing and tissue and makes the nerves and muscles of the pelvic floor contract. BTL says the field makes the pelvic floor contract more often and more strongly than you can voluntarily. The US regulator's 2018 summary for BTL's pelvic floor chair describes the field as 0.7 to 2.5 tesla at 1 to 150 pulses a second, for up to 30 minutes.

BTL describes a session as thousands of Kegel-like contractions, with its 2019 figure at 11,000. The aim is the same as the aim of pelvic floor exercises: a stronger, more responsive pelvic floor that closes the urethra when you cough, sneeze, laugh or run, and that helps the bladder hold on when it wants to go.

You stay dressed. You sit on the chair with your feet on the floor, the clinician sets the intensity, and for 28 minutes you feel strong tingling and the muscles pulling and releasing. There is no probe, no electrode on the skin and no undressing.

Does Emsella really work?

Yes, for stress and mixed incontinence in women: most women in the published studies reported improvement. Here are the numbers.

• The main study (Samuels, 2019) treated 75 women, average age 55, with six 28-minute sessions over three weeks. Their score on the standard incontinence questionnaire (ICIQ-SF) fell from 10.6 to 4.2 at three months in the 61 women assessed, a 64% improvement. 81% reported a significant reduction in symptoms after the sixth session. Among the 43 who used pads at the start, pad use fell by 54% at three months; 35% of them needed no pads after the sixth session and 44% at three months. The study had no comparison group.
• A second single-arm study (Tosun, 2024) treated 35 women: the same score fell by 60% at one month, and 31% scored zero.
• A retrospective, non-randomised comparison in women aged 18 to 45, at least six months after a vaginal birth (Silantyeva, 2021), found a 52% improvement in pelvic floor symptoms with ten sessions on the chair. The comparison group, on a home electrical stimulator that is not FDA-cleared, improved by 18%, measured straight after treatment.
• Urge incontinence responded less early: in the main study the urge-only group improved by 27% after the sixth session and 54% at three months, against 67% for stress incontinence.
• At nine months, a conference report on 33 women found scores still 60% lower. Sham-controlled trials of the chair are registered, and some are still recruiting.

So what the studies show is a meaningful reduction in leaks for most women with stress or mixed incontinence, seen by the end of the course and greater again at three months. The studies are small, so we measure your own result with the same questionnaire at the consultation, at the end of the course and at six months.

What the evidence supports:

• Stress incontinence: leaking with a cough, a sneeze, a laugh, a run or a lift.
• Mixed incontinence, where urgency and stress leaks both happen.
• Leaks from weak pelvic floor muscles after childbirth, once the body has recovered.

What Emsella does not do:

• It is not a treatment for pelvic organ prolapse, which is not a cleared indication; we assess for prolapse at the consultation before we book you.
• It does not fix an overactive bladder on its own, and it is not for overflow incontinence or a neurological bladder problem.
• It is not a treatment for erectile dysfunction, where one trial is still recruiting; we use the chair for urinary leaks.

Who Emsella suits, and who it does not

BTL's pelvic floor chair is cleared in the US for urinary incontinence in women and men. Most of the evidence is in women with an average age of about 50 to 55 with stress or mixed incontinence, and the chair is used for men after prostate surgery, where one study of 27 men found symptom scores about 60% lower at one month.

The full contraindication list is in BTL's user manual for clinics. The list below is the exclusions used in the clinical trials and in common practice, and we check it against the manual at your consultation:

• A pacemaker, a defibrillator or any implanted electronic device.
• Metal implants in the pelvic area, including a hip replacement, or a copper coil (IUD). Tell us about any coil and we check the manufacturer's guidance before we book you.
• Pregnancy, planning a pregnancy, and at least the first three months after giving birth (the exclusion used by a health-technology review).
• Recent pelvic or abdominal surgery that is still healing.
• An untreated cancer.
• Under 18.

Treatment during a period is the clinician's call; ask at the consultation. If you have a bleeding disorder, epilepsy or an active pelvic infection, bring your history and the clinician decides case by case.

Nothing about Emsella is injected or inserted. If you have had bladder injections, tell us when and how they worked; the clinician will decide whether to go ahead.

What a course is like, step by step

1. Consultation. The clinician asks about your leaks, what sets them off, what you have already tried, and whether there is any sign of prolapse or a condition that needs medical assessment first. In our practice you also answer the ICIQ-SF questionnaire the studies use, so there is a number to compare with later. Consultations and follow-up reviews are free.
2. The first session. You sit on the chair in your clothes, feet flat, and the clinician raises the intensity in steps until the contractions are strong but comfortable.
3. The course. Six sessions, twice a week, over three weeks, 28 minutes each; that is the protocol used in the published studies and the one we follow. You can read or talk during the session; ask us about your phone.
4. After each session. You walk out. In our experience some people feel muscle fatigue or mild soreness in the pelvic floor for a day, as after exercise. The main study reported no downtime.
5. Review. Our protocol is a review at the end of the course and again at six months, with the same questionnaire each time.

How many sessions, when you see the result, how long it lasts

Is one session enough to tell? No. A single session shows you what it feels like, not what it does; the studies and our protocol use six.

What Emsella costs in London

Emsella is priced per session, and a course is six sessions over three weeks. We price Emsella from a starting price per session and per course, confirmed in writing at your free consultation, and we price match any comparable written quote. Finance is available, subject to status, with terms that depend on the amount. Consultations and follow-up reviews are free whatever you decide.

Results you can check

Leaks do not show in a photograph, so we measure them with a questionnaire score instead: in our practice we ask you the ICIQ-SF questions the studies use at the consultation, at the end of the course and at six months, so you can see your own numbers.

Patients have reviewed the clinic on review.clinic, the review service we use, where Emsella at our clinic holds 4.9 out of 5 from 107 reviews, with 98% saying the treatment was worth it (November 2026). Read the ones that say what the leaks were like before; they are the most useful.

Is Emsella available on the NHS?

Not as part of the standard NHS pathway: Emsella is a private treatment, and NICE, which decides what the NHS should use, has not assessed it. What NICE recommends as first-line treatment for stress or mixed incontinence in women is supervised pelvic floor muscle training for at least three months. That means at least eight contractions, three times a day, with a physiotherapist or continence nurse checking you are doing them right.

The chair works alongside that training, not instead of it: it makes the same muscles contract for you, and we recommend doing both. It suits people who want to add stimulated contractions to their exercises, who have tried exercises without enough change, or who cannot feel the muscles well enough to train them. You do not need a GP referral to book a free consultation with us.

Does the Emsella chair fix prolapse?

No. A prolapse is the bladder, bowel or womb pressing into the vagina because its support has stretched. Prolapse is not a cleared indication for the chair, and one health-technology review excludes stage three or higher. NICE suggests supervised pelvic floor training for at least 16 weeks for a stage 1 or 2 prolapse with symptoms. If your leaks come with a dragging feeling, a bulge or difficulty emptying, tell us when you book: the clinician assesses for prolapse at the free consultation and tells you whether the chair is right for you or what to do next.

Emsella compared with the alternatives

The evidence and session rows reflect the sources named; the "who it suits" row reflects our clinical experience.

Emsella vs Kegels. They train the same muscles and they work together. The chair does the contractions for you, which in our clinical experience suits people who cannot feel the muscles or struggle to keep up exercises, and the exercises keep the muscle working between sessions and after the course. A 2022 health-technology review described the chair as an adjunct to a physiotherapy programme, and that is how we use it: do both.

Emsella vs EMfemme 360. They treat different problems, and we provide both at 8 Devonshire Place. The chair strengthens the pelvic floor muscles with a magnetic field, for urinary leaks. EMfemme 360 warms the vaginal tissue with radiofrequency; its maker describes it for vaginal laxity, not for leaks. The clinician tells you at the consultation which fits your symptoms.

Emsella vs surgery. Surgery lifts and holds; the chair strengthens, with no operation, and you walk out and carry on with your day. If you have been offered an operation for stress incontinence, ask at the consultation whether trying the chair alongside pelvic floor exercises first is reasonable for you; it is not a reason to refuse surgery you need.

Side effects, and who should not have it

The US regulator's summary lists the side effects that can accompany the treatment: muscular pain, temporary muscle spasm, temporary joint or tendon pain, a temporary increase in local circulation, increased sensitivity during intercourse, and redness of the skin. The main study reported no treatment-related adverse events, with minor muscle fatigue noted; a second reported mild, passing side effects without counts; and a 2025 review calls side effects uncommon and mild where they were recorded, with inconsistent reporting.

In our experience the common complaints are a feeling of having exercised and tingling that lasts an hour. Tell the clinician if the contractions are painful rather than strong; the intensity comes down.

The clinician checks the exclusions above at the consultation, especially metal or electronics in the pelvis, and assesses for prolapse. Blood in the urine, pain, a sudden change in symptoms or leaks that started with a new medicine need your GP first.

How to choose an Emsella clinic in London

• Ask what they will measure. A clinic that runs the ICIQ-SF questionnaire before and after is a clinic that expects to show you a result. Ours does.
• Ask who assesses you and who supervises. Our sessions are run by trained clinicians in a doctor-led team, and this guide is reviewed by Dr Marie Duggan, GMC 7488383.
• Ask about prolapse. The chair does not treat prolapse, so a good clinic assesses for it before it books you; ours does, at the free consultation.
• Ask for the course price, not the session price. A single taster session is one of the six you need.
• Check the device. A genuine BTL Emsella chair; ask the clinic to show you the device and its BTL branding.
• Check the regulator. The clinic should be CQC registered. Ours is, registered at our group's Harley Street address.

Aftercare

There is nothing to do after a session. Keep doing your pelvic floor exercises, because the muscle you build on the chair is the same muscle, and keep a note of your leaks through the course so the review means something. Drink normally; cutting fluids to avoid leaks makes urgency worse. If you are seeing a physiotherapist, tell them you are having the chair, and tell us what they have advised.

Frequently asked questions