The magic magnetic chair how to facilitate best
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The magic magnetic chair- how to facilitate best. Daniela Marschall-Kehrel, Frankfurt. 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

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The magic magnetic chair how to facilitate best

The magic magnetic chair-how to facilitate best

Daniela Marschall-Kehrel, Frankfurt


What is evidenced based medicine

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


Sui post rpx pfmt vs mft n 105 2 arms no cross over

SUI post RPx; PFMT vs MFT: n=105, 2 arms no cross over

  • Start 1 week after catheter was removed (16.8=dry). MFT 2x20weeks 30‘ follow-up: 4 weeks, 3, 6+12mo.

  • Continence

    • I: 51%, 64%, 82%

    • II: 44%, 50%, 68%

  • Pad test I=p=0.004 after 12mo

  • Qol significantly better (no numbers)


Mixed incontinence both genders n 49 24 active 25 placebo

Mixed incontinence both genders n=49 24=active 25=placebo

  • 3x6weeks; 1st: intermitt. 5Hz 10‘, 3‘rest 2nd: intermitt 50Hz 10‘; follow-up: 8weeks. Only active=14 and placebo=19 eligable

  • SUI:

    • Active: pad test significant p=0.002

    • Placebo: worse 47% to 68%

  • OAB:

    • Urgency: active p=0.09

    • Wet: active=0 (21% before), placebo=no change

  • Pad weight

    • Active: mean 2.59g p=0.079

    • Placebo: mean 14.67

  • Qol

    • Active: p=0.04

    • Placebo: p=0.56


Ui 3mo post rpx n 27 11 active 16 placebo

UI 3mo post RPx n=27 11=active, 16=placebo

  • 2x6weeks sham pat. had cross over 6wks

  • Pads/day

    • 1.41 to 0.53 62% p>0.04; 6/9=continent

    • Cross over 1.89 to 1.17

  • Incontinence episodes

    • 3.42 to 0.9173% p>0.01

  • Pad weight

    • 4.81 to 3.81 p>0.03

    • Cross over 5.78 to 1.5 p>0.05

  • Qol positive trends


Sui qol women n 66

SUI-Qol women n=66

  • 2x6weeks 1st: 5Hz 10‘ 2nd: 50Hz 10‘

  • Qol

    • 53/66 80% p=0.01 improved

      • Incontinece episodes 40/53 0<0.01

      • Pad changes 46/53 p<0.01

    • 12/66 decreased Qol

      • Incontinence episodes 4/12 p>0.05

      • Pad changes 5/12 p>0.05

  • Urinary frequency

    • 20/33 decreased p=0.002

    • 13/33 increased p missing


Ic cpps treatment failures n 10 investigator initiated trial

IC/CPPS treatment failures n=10, 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


Sui females n 64 follow up 3mo n 51

SUI females n=64, follow-up 3mo n=51

  • 2x6weeks

  • Incontinence

    • 18/51 34% continent

  • Pad/day

    • 1/day 16/51 32% 2.5 to 1.3 p=0.001

  • Leak episodes

    • 3.3 to 1.7 p=0.001

  • UD

    • ALLP 43 to 48 cmH2O

    • DO 5/51 to 1/51 p=0.001

  • 6 month follow-up n=36

    • 10/36 28% continent

    • 8/36 22% 1 pad/day


Orgasmic performance in women n 20 7 20 not sexual activ

Orgasmic performance in women n=20, 7/20 not sexual activ

  • OAB wet questionaire(6 questions) n=13

  • 6/13 no changes

  • 2/13 worse

  • 5/13 improved

  • Age was most reliable (<55ys)


Cpps iii niddkd treatment failures n 21 11 activ 10 placebo

CPPS III NIDDKD treatment failures n=21 11=activ 10=placebo

  • 2x4weeks 1st: cont.10Hz 15‘ 2nd: cont.50Hz 15‘ follow-up 3mo and 1y

  • Pain score

    • 3mo p<0.05

    • 1y p<0.05

  • Urinary symptom score

    • 3mo p<0.05

    • 1y not significant


From theory to practise

From theory to Practise


The magic magnetic chair how to facilitate best

SUI

  • Intermitt 5-5 50 Hz 20‘ 100% 3x4-6wk

  • +/- Duloxetin


The magic magnetic chair how to facilitate best

OAB

  • Intermitt. 5-5 2Hz 20‘ 100% 3x4wk

  • Antimuscarinics?


Cpps ic

CPPS/IC

  • Diclofenac 100mg Supp 10‘ before treatment

  • 1st: intermitt. 5-5 50Hz 50% 15‘min 3-5x4weeks

  • 2nd: cont. 5Hz 100% 15‘ see above


The magic magnetic chair how to facilitate best

ED

  • PGE5I cont., SCAT in TF?

  • 1st: intermitt.8-4 24Hz 15‘ 3x4weeks

  • 2nd:intermitt.6-3 24Hz 15‘ s.a.


Sui after rpx

SUI after RPx

  • Intermitt 5-5 50Hz 100% 3-5x 4weeks

  • If OAB: intermitt. 5-5 5Hz 100% 3x4wks


Cpps chronic prostatitis

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


No personal experience

No personal experience

  • Fecal incontinence

  • Ogasmproblems

  • Ejaculationpower

  • Acute pain

  • Muscle volume


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