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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?. 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

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

  2. 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

  3. 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)

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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)

  10. 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

  11. From theory to Practise

  12. SUI • Intermitt 5-5 50 Hz 20‘ 100% 3x4-6wk • +/- Duloxetin

  13. OAB • Intermitt. 5-5 2Hz 20‘ 100% 3x4wk • Antimuscarinics?

  14. 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

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

  16. SUI after RPx • Intermitt 5-5 50Hz 100% 3-5x 4weeks • If OAB: intermitt. 5-5 5Hz 100% 3x4wks

  17. 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

  18. No personal experience • Fecal incontinence • Ogasmproblems • Ejaculationpower • Acute pain • Muscle volume

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