Effects of magnetic stimulation in the treatment of pelvic floor dysfunction

• Published in: BJU international Vol. 97; no. 5; pp. 1035 - 1038
• Main Authors: VOORHAM–VAN DER ZALM, PETRA J., PELGER, ROB C.M., STIGGELBOUT, ANNE M., ELZEVIER, HENK W., LYCKLAMA À NIJEHOLT, GUUS A.B.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.05.2006; Blackwell
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Defecation; Diseases of the urinary system; electrostimulation; Exercise Therapy; Female; Humans; incontinence; magnetic stimulation; Magnetics; Male; Medical sciences; Middle Aged; Muscular Diseases - physiopathology; Muscular Diseases - rehabilitation; Nephrology. Urinary tract diseases; pelvic floor; Pelvic Floor - physiopathology; Physical Stimulation - methods; Pilot Projects; Quality of Life; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Urinary Incontinence - therapy; Urinary Incontinence, Stress - therapy; Urinary system involvement in other diseases. Miscellaneous; Urinary tract. Prostate gland; Human; Nephrology; Urinary system disease; magnetic stimulation; Electrical stimulus; Physiotherapy; electrostimulation; Urinary tract disease; Urology; Voiding dysfunction; Pelvic floor; Treatment; incontinence; Dysfunction; Magnetic stimulus; Bladder disease; Urge urinary incontinence; Urinary stress incontinence
• ISSN: 1464-4096; 1464-410X
• DOI: 10.1111/j.1464-410X.2006.06131.x

OBJECTIVE To correlate, in a pilot study, the clinical results of extracorporeal magnetic innervation therapy (ExMI) of the pelvic floor muscles with functional changes in the pelvic floor musculature, urodynamics and quality of life. PATIENTS AND METHODS In all, 74 patients (65 women and nine men) with urge incontinence, urgency/frequency, stress incontinence, mixed incontinence and defecation problems were included in a prospective study of ExMI using a ‘electromagnetic chair’. All patients were treated twice weekly for 8 weeks. Digital palpation and biofeedback with a vaginal or anal probe were used for registration of the pelvic floor musculature. A urodynamic evaluation, a voiding diary, a pad‐test, the King's Health Questionnaire (KHQ) and a visual analogue scale (VAS) were completed by the patient at baseline and at the end of the study. RESULTS In the group as a whole, there were no significant differences in the voiding diary, pad‐test, quality of life, VAS score, biofeedback registration and urodynamics before and after treatment. Additional stratification was applied to the total patient group, related to the pretreatment rest tone of the pelvic floor, the basal amplitude registered on electromyography, to age and to previous treatments. However, there were no significant differences in the data before and after treatment within all subgroups (stress incontinence, urge incontinence, urgency/frequency, defecation problems, overactive pelvic floor, age, previous treatments), except for the KHQ domain of ‘role limitations’, where there was a significant improvement in all groups. CONCLUSION ExMI did not change pelvic floor function in the present patients. The varying outcomes of several studies on ExMI stress the need for critical studies on the effect and the mode of action of electrostimulation and magnetic stimulation. In our opinion ‘the chair’ is suitable to train awareness of the location of the pelvic floor. However, active pelvic floor muscle exercises remain essential.