Effects of magnetic stimulation in the treatment of pelvic floor dysfunction.
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.


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.


CONCLUSIONS
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.
Voorham-van der Zalm
Petra J
PJ
Department of Urology, Leiden University Medical Center, the Netherlands. pjvoorham@lumc.nl
Pelger
Rob C M
RC
Stiggelbout
Anne M
AM
Elzevier
Henk W
HW
Lycklama à Nijeholt
Guus A B
GA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003672:Defecation; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008280:Magnetics; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000503:physiopathology / Q000534:rehabilitation*; D017773:Pelvic Floor / Q000503:physiopathology*; D010812:Physical Stimulation / Q000379:methods*; D010865:Pilot Projects; D011788:Quality of Life; D014549:Urinary Incontinence / Q000628:therapy*; D014550:Urinary Incontinence, Stress / Q000628:therapy