Eight sessions of pelvic floor muscle electrostimulation combined with EMG biofeedback will be provided over a two-week period (four sessions per week). The intervention will be delivered using a specialized EMG-Biofeedback electrostimulation device equipped with a screen for real-time signal visualization. Vaginal electrodes will be used to ensure precise stimulation and accurate detection of pelvic floor muscle activity. During each 30-minute session, patients will receive symmetrical biphasic rectangular electrical impulses at a frequency of 50 Hz, with a 5-second stimulation phase followed by a 10-second rest period. The intensity of the stimulation will be individually adjusted to ensure both safety and comfort. The integrated biofeedback system will allow participants to observe their muscle activation patterns on the screen, enhancing their awareness and control of pelvic floor function and supporting the learning of correct activation during voluntary contractions.

The PISQ-IR evaluates sexual function in women with urinary incontinence or pelvic organ prolapse. It includes separate domains for sexually active and inactive women, assessing aspects such as desire, satisfaction, and emotional impact. Higher scores in each domain indicate better sexual function and less impact of symptoms.

The Gaudenz Questionnaire assesses urinary incontinence severity through structured questions on leakage frequency, volume, triggers, and pad usage. It provides a detailed clinical profile of symptom severity, though not a single summary score.

The KHQ is a validated quality-of-life tool for individuals with urinary incontinence. It includes multiple domains such as general health perception, role limitations, physical limitations, social relationships, emotions, and sleep/energy. Each domain is scored on a 0-100 scale, with higher scores indicating greater impairment.

The KPS is a validated Polish-language instrument designed to measure perceived stress in women. It evaluates subjective feelings of strain, tension, and inability to cope. Higher scores indicate higher levels of perceived stress.

The SES is a 10-item scale measuring global self-esteem. The Polish adaptation maintains the original structure and uses a 4-point Likert scale. Scores range from 10 to 40, with higher values reflecting higher self-esteem.

Pelvic organ prolapse (POP) will be evaluated using translabial ultrasound in the midsagittal plane. The presence and grade of anterior (cystocele), posterior (rectocele, enterocele), and apical (uterine or vaginal vault) prolapse will be determined relative to the inferoposterior margin of the symphysis pubis. POP grade will be classified according to the pelvic organ prolapse quantification system (POP-Q) or equivalent ordinal scale (Stage 0-IV). Higher stage values indicate more advanced prolapse severity.

Urethral morphology will be assessed using transvaginal or translabial ultrasound. Structural integrity will be evaluated by identifying any abnormalities such as urethral diverticula, periurethral cysts, strictures, or focal discontinuities. Urethral length will be measured in millimeters (mm), from the bladder neck to the external urethral meatus. Structural defects will be reported categorically as present or absent. The presence of structural abnormalities is considered pathological. Shortened or disrupted urethral length may indicate structural compromise.

Bladder wall characteristics will be examined using transabdominal or translabial ultrasound. Thickness of the bladder wall will be measured in millimeters (mm) at the anterior wall with the bladder in a full state. Additional findings such as trabeculation, diverticula, or focal wall deformities will be documented as present or absent. Increased bladder wall thickness or the presence of structural abnormalities is considered indicative of chronic bladder dysfunction and is interpreted as adverse.

Bladder neck mobility will be assessed using transvaginal or translabial ultrasound at rest and during the Valsalva maneuver. The degree of descent will be calculated as the displacement angle (in degrees) of the bladder neck relative to the pubic symphysis. An angle greater than 30-45° indicates hypermobility, which is considered pathological and commonly associated with stress urinary incontinence.