Case Studies supporting PEMF benefits for Incontinence
Clinical Outcomes involving the Use of Extracorporeal Magnetic Innervation in the Treatment of Urinary Incontinence
Urinary incontinence is defined as the involuntary loss of urine from the bladder (Craven & Hirnle, 2003). According to Sakamoto, Sharma, and Wheeler (2007) this is a problem that affects approximately 25 million Americans. Anatomical differences, trauma that can occur during childbirth and hormonal changes brought about by menopause predispose women to be disproportionately affected by urinary incontinence more than men (Katz, 2009). It is estimated that 50% of all women will experience some form of urinary incontinence in their lifetime (Melville, Katon, Delaney, & Newton, 2005; Huang et al., 2006). The overall prevalence of urinary incontinence in ambulatory men is reported at around 30% (Smoger, Felice, & Kloecker, 2000). Of men who have undergone radical prostatectomy, up to 69% have reported some post-surgical incontinence (Hollenbeck et al., 2002). It is of interest that men report more social limitation and more frustration and shame from urinary incontinence than women (Lagro-Janssen, Hilkens, Klaasen, & Teunissen, 2008).
It is difficult to predict the financial cost of urinary incontinence with any precision since most projections fail to take into consideration inflation and increases in the cost of medical care and supplies, however, the yearly expense of incontinence care is estimated at over $27 billion. This expense is attributed to catheters, containment devices, laundry services, medical care for infections, injuries sustained in falls, prolonged hospital stays, and the indirect costs of lost time from work for patients or 2 caregivers (Kerr, 2005; Landefeld, et al., 2008). In addition to the high financial cost of urinary incontinence, there is personal degradation from the negative physical, social, and emotional impact of this dysfunction.
Urinary incontinence is categorized according to etiology and is commonly referred to as stress, urge, mixed, reflex, overflow, or functional incontinence. Stress and mixed urinary incontinence (symptoms of both stress and urge) predominate (Diokno et al., 2003; Kristensen, Eldoma, Williamson, Wood, & Mainprize, 2010). Treatment is based on the type of incontinence the patient is experiencing and includes self management strategies, behavioral therapies, pelvic floor rehabilitation, medications and surgery.
EXTRACORPOREAL MAGNETIC INNERVATION THERAPY FOR STRESS URINARY INCONTINENCE
Objectives: To report the first data from a prospective clinical study to determine the feasibility of using extracorporeal magnetic innervation (ExMI) for the treatment of stress urinary incontinence.
Methods: We studied 83 women with demonstrable stress urinary incontinence. Treatments were for 20 minutes, twice a week for 6 weeks. For treatment, the patient sits fully clothed on a special chair; within the seat is a magnetic field generator that produces the rapidly changing magnetic field flux. Objective measures included bladder diaries, dynamic pad weight testing, urodynamic studies, and quality of life survey.
Results: Fifty patients have been followed up for longer than 3 months (33 patients for less than 3 months); 17 patients (34%) were dry, 16 (32%) were using not more than 1 pad per day, and 17 (34%) were using more than 1 pad per day. Pad use was reduced from 2.5 to 1.3 (P 5 0.001) and leak episodes per day were reduced from 3.3 to 1.7 (P 5 0.001). The pad weight was reduced from 20 to 15 g. Detrusor instability was found in 5 patients before but was demonstrated in only 1 patient after treatment.
Conclusions: ExMI therapy offers a new effective modality for pelvic floor muscle stimulation. ExMI is painless, there is no need for a probe, and no need to undress for treatments. Longer follow-up is required to determine how long the benefits of treatment last and whether retreatment will be necessary.
PULSATING ELECTROMAGNETIC FIELD STIMULATION OF UROTHELIAL CELLS INDUCES APOPTOSIS AND DIMINISHES NECROSIS: NEW INSIGHT TO MAGNETIC THERAPY IN UROLOGY
Electromagnetic field (EMF) induces cell death, therefore it seems to be an option for noninvasive treatment with low side effect risks and without problems of drug interactions in chronic inflammatory diseases (1). Pulsating electromagnetic field (PEMF) stimulation showed antiinflammatory effects in Crohn's disease patients by induction of peripheral blood mononuclear cells apoptosis and changes in cytokine profile (2). In the last decade, extracorporeal EMF stimulation of pelvic muscle floor has been introduced for treating urge and/or stress urinary incontinence, and also overactive bladder (OAB) (3, 4).
The urothelium as an "active barrier" plays an important role in storage and voiding via detrusor muscle motor activity modulation, as well as seeming to contribute to OAB and LUT (lower urinary tract) symptoms (5). Neurogenic and myogenic mechanisms, and also changes in the urothelium underlying overactive bladder (OAB) have been described (6). In response to different stimuli, urothelial cells can release many substances including prostaglandins (PG), adenosine triphosphate (ATP), nitric oxide (NO), acetylcholine (Ach), etc. which affect urinary bladder compartments (smooth muscle, afferent and efferent nerve endings, interstitial and immune cells). Afferent nerve fibres stimulation (via vanilloid TRPV16 and ankyrin TRPA1 receptors) may release substance P (SP), calcitonin generelated peptide (CGRP) and interleukins generating blood vessels, mastocytes and lymphocytes response, and, in a consequence, alter the urinary bladder sensory and/or motor activity due to neurogenic inflammation (79). Overstimulation of afferent unmyelinated Cfibres and its local effector function (via neurogenic inflammation) by substances released from urothelium may induce detrusor overactivity leading to OAB symptoms and/or urge incontinence (10, 11). Diminishing the release of the urothelial cells' mediators to reduce afferent nerve overstimulation seems to be crucial in urinary bladder sensory and motor activity control. Moreover, there is still no evidence on the influence of PEMF on the urothelium.
Therefore, the objective of our study was to examine the effect of pulsating electromagnetic field (PEMF) stimulation on rat urothelial cultured cells (RUCC).
Case Study Reference Source:
1. Clinical Outcomes involving the Use of Extracorporeal Magnetic Innervation in the Treatment of Urinary Incontinence
(Authors: Kathy Davis)
2. EXTRACORPOREAL MAGNETIC INNERVATION THERAPY FOR STRESS URINARY INCONTINENCE
(Authors: NIALL T. M. GALLOWAY, RIZK E. S. EL-GALLEY, PETER K. SAND, RODNEY A. APPELL, HOWARD W. RUSSELL, AND STEPHEN J. CARLAN)
3. PULSATING ELECTROMAGNETIC FIELD STIMULATION OF UROTHELIAL CELLS INDUCES APOPTOSIS AND DIMINISHES NECROSIS: NEW INSIGHT TO MAGNETIC THERAPY IN UROLOGY
(Authors: K. JUSZCZAK1, J. KASZUBAZWOINSKA, P.J. THOR)