The magic magnetic chair- how to facilitate best

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The magic magnetic chair-how to facilitate best

• Daniela Marschall-Kehrel, Frankfurt

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What is evidenced based medicine?

• SUI post RPx 2 Publications
• Mixed incontinence in both genders
• SUI/Qol
• IC/CPPS (females)
• SUI in females
• Sexual performance in women
• CPPS/chronic prostatitis III NIDDKD

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SUI post RPx PFMT vs MFT n105, 2 arms no cross
over

• Start 1 week after catheter was removed
  (16.8dry). MFT 2x20weeks 30 follow-up 4 weeks,
  3, 612mo.
• Continence
• I 51, 64, 82
• II 44, 50, 68
• Pad test Ip0.004 after 12mo
• Qol significantly better (no numbers)

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Mixed incontinence both genders n49 24active
25placebo

• 3x6weeks 1st intermitt. 5Hz 10, 3rest 2nd
  intermitt 50Hz 10
  follow-up 8weeks. Only active14 and placebo19
  eligable
• SUI
• Active pad test significant p0.002
• Placebo worse 47 to 68
• OAB
• Urgency active p0.09
• Wet active0 (21 before), placebono change
• Pad weight
• Active mean 2.59g p0.079
• Placebo mean 14.67
• Qol
• Active p0.04
• Placebo p0.56

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UI 3mo post RPx n27
11active, 16placebo

• 2x6weeks sham pat. had cross over 6wks
• Pads/day
• 1.41 to 0.53 62 pgt0.04
  6/9continent
• Cross over 1.89 to 1.17
• Incontinence episodes
• 3.42 to 0.9173 pgt0.01
• Pad weight
• 4.81 to 3.81 pgt0.03
• Cross over 5.78 to 1.5 pgt0.05
• Qol positive trends

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SUI-Qol women n66

• 2x6weeks 1st 5Hz 10 2nd 50Hz 10
• Qol
• 53/66 80 p0.01 improved
• Incontinece episodes 40/53 0lt0.01
• Pad changes 46/53 plt0.01
• 12/66 decreased Qol
• Incontinence episodes 4/12 pgt0.05
• Pad changes 5/12 pgt0.05
• Urinary frequency
• 20/33 decreased p0.002
• 13/33 increased p missing

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IC/CPPS treatment failures n10, investigator
initiated trial

• 2x8weeks maximum voltage therapy
• 9/10 improved frequency, pain, urgency
• 3/10 total relief of symptoms but not long
  lasting
• 1/10 failed

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SUI females n64, follow-up 3mo n51

• 2x6weeks
• Incontinence
• 18/51 34 continent
• Pad/day
• 1/day 16/51 32 2.5 to 1.3 p0.001
• Leak episodes
• 3.3 to 1.7 p0.001
• UD
• ALLP 43 to 48 cmH2O
• DO 5/51 to 1/51 p0.001
• 6 month follow-up n36
• 10/36 28 continent
• 8/36 22 1 pad/day

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Orgasmic performance in women n20, 7/20 not
sexual activ

• OAB wet questionaire(6 questions) n13
• 6/13 no changes
• 2/13 worse
• 5/13 improved
• Age was most reliable (lt55ys)

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CPPS III NIDDKD treatment failures n21 11activ
10placebo

• 2x4weeks 1st cont.10Hz 15 2nd
  cont.50Hz 15 follow-up 3mo and 1y
• Pain score
• 3mo plt0.05
• 1y plt0.05
• Urinary symptom score
• 3mo plt0.05
• 1y not significant

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From theory to Practise
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SUI

• Intermitt 5-5 50 Hz 20 100 3x4-6wk
• /- Duloxetin

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OAB

• Intermitt. 5-5 2Hz 20 100 3x4wk
• Antimuscarinics?

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CPPS/IC

• Diclofenac 100mg Supp 10 before treatment
• 1st intermitt. 5-5 50Hz 50 15min 3-5x4weeks
• 2nd cont. 5Hz 100 15 see above

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ED

• PGE5I cont., SCAT in TF?
• 1st intermitt.8-4 24Hz 15 3x4weeks
• 2ndintermitt.6-3 24Hz 15 s.a.

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SUI after RPx

• Intermitt 5-5 50Hz 100 3-5x 4weeks
• If OAB intermitt. 5-5 5Hz 100 3x4wks

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CPPS/chronic Prostatitis

• Ciproflox 200 iv 5 before start MFT and 500mg
  evening dosage if pain is dominant add
  Diclofenac 100mg Supp 10 before treatment
• Intermitt.5-5 60Hz 55 daily 5-10 days
• If pain cont. 5Hz 100 10/break 2/10 3-5/week

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No personal experience

• Fecal incontinence
• Ogasmproblems
• Ejaculationpower
• Acute pain
• Muscle volume