When we introduced the treatment principle of high-intensity focused electromagnetic field before, we learned that it can not only train muscles but also promote the repair of various connective tissues.
(https://uroprolo.blogspot.com/2023/03/mechanism-and-application-of-high.html)
This time, we will further explore what kind of therapeutic effect will happen if it is applied to the treatment of urinary incontinence.
Below are some representative studies.
Safety and Efficacy of a Non-Invasive High-Intensity Focused Electromagnetic Field (HIFEM) Device for Treatment of Urinary Incontinence and Enhancement of Quality of Life
https://pubmed.ncbi.nlm.nih.gov/31172580/
This study enrolled 75 patients with three types of urinary incontinence (mean age 55.45 years) who had not received any prior urinary incontinence treatment.
The treatment involved high-intensity focused electromagnetic field therapy twice a week for a total of six treatments.
The treatment effectiveness was evaluated by the absorbent pads used per day and the ICIQ-SF questionnaire.
Results:
61 patients (81%) experienced a significant reduction in urinary incontinence symptoms after six treatments. There was a significant improvement in quality of life (ICIQ-SF improvement of 49.93%).
The treatment effect was maintained after a 3-month follow-up period (ICIQ-SF improvement of 64.42%).
The most significant improvement was observed in patients with mixed urinary incontinence (ICIQ-SF improvement of 69.9%).
70% of patients reported decreased number of used pads.
After reading this study, my impression is that if we the treatment effect is so excellent with HIFEM one course only, then the effect can be further enhanced by combining it with mediation and increasing the courses of treatments.
Additionally, it can be observed that even after a 3-month follow-up period, the treatment effect not only persisted but also continued to improve (Note 1).
This suggests that HIFEM does not simply train the muscles (as stopping training would result in either maintenance or regression), but also has a therapeutic effect on tissue repair, leading to sustained improvement even after treatment cessation.
Furthermore, based on past treatment experience and research, self-training of the pelvic floor muscles cannot guarantee the quality and duration of the training.
Patients who wish to achieve therapeutic effects through self-training of the pelvic floor muscle group typically require 12 to 40 weeks of training.
In contrast, HIFEM equipment ensures the quality of each treatment, and the treatment effect was observed within just 3 weeks. The therapeutic benefits of this treatment are evident.
The previous study results inferred that HIFEM has a repairing effect on pelvic floor tissues. So, is there more direct evidence?
Yes, there is.
A Comparative Study on the Effects of High-Intensity Focused Electromagnetic Technology and Electrostimulation for the Treatment of Pelvic Floor Muscles and Urinary Incontinence in Parous Women: Analysis of Posttreatment Data
https://pubmed.ncbi.nlm.nih.gov/31860567/
This study enrolled 95 parous women, divided into three groups:
1. Group 1: 50 urinary incontinence patients receiving 10 sessions of high-intensity focused electromagnetic (HIFEM) therapy (n = 50, HIFEM)
2. Group 2: 25 urinary incontinence patients receiving electrical stimulation therapy (n = 25, electrical stimulation)
3. Group 3: 20 healthy subjects as a control group (no treatment) (n = 20, control group)
Patients underwent examination by 3-dimensional transperienal ultrasound at the baseline and posttreatments.
Levator-urethra gap, anteroposterior diameter, laterolateral diameter of levator hiatus, and hiatal area were measured.
They also completed the Pelvic Floor Disability Index 20 questionnaire and subjective evaluation of intimate health.
Results:
Only Group 1 patients showed significant improvement on ultrasound examination after treatment (decreased anteroposterior diameter, laterolateral diameter, and hiatal area).
Group 1 patients achieved greater improvement in the Pelvic Floor Disability Index questionnaire compared to Group 2 (52% vs. 18%; P < 0.001), and there was a significant reduction in patients with urinary leakage after treatment.
My personal impression is that most studies on urinary incontinence focus on subjective questionnaire surveys, with pad usage as a secondary objective (also often assessed by questionnaire).
This study is one of the few urinary incontinence treatment-related studies that evaluate treatment effects based on both subjective (questionnaire survey) and objective examination (3D transperineal ultrasound) methods.
Furthermore, not only tissue repair but also muscle contractility can be objectively confirmed (by electromyography), proving the effectiveness on the pelvic floor muscles training.
https://pubmed.ncbi.nlm.nih.gov/32146133/
Final question.
How long does the effect of high-intensity electromagneticfield therapy last?
Currently, there is a lack of studies with longer follow-up.
According to studies from traditional magnetic stimulation machines (Note 2), even after one year, the therapeutic effect can still be maintained.
Moreover, the more treatment sessions, the better the effect.
https://pubmed.ncbi.nlm.nih.gov/27871927/
https://pubmed.ncbi.nlm.nih.gov/28791447/
Summay:
High-intensity focused electromagnetic field treatment of urinary incontinence has the following advantages
1. Non-invasive (better than surgery)
2. No side effects (better than drugs)
3. The curative effect is fast and effective (better than self-training and traditional magnetic stimulation chair)
4. Helps tissue repair, long-lasting effect (better than other treatment methods like electrotherapy, surgery, drugs)
5. Improves quality of life
Certainly, this does not mean that other treatment modalities should be discarded.
Every treatment has a role.
Clinically, different treatment methods are often combined at the same time to achieve the best therapeutic effect.
Therefore, patients with urinary incontinence problems should still seek professional medical assistance to receive appropriate treatment recommendations and prescriptions.
#Emsella
#SIS(super inductive system)
Other references：
https://pubmed.ncbi.nlm.nih.gov/34768730/
https://pubmed.ncbi.nlm.nih.gov/35447699/
(Note 1: The average ICIQ-SF score of the patients was 10.57 ± 4.22, which decreased to 5.33 ± 3.97 after six treatments, and further decreased to 4.16 ± 4.04 points in the 3-month follow-up. After six treatments, 13 patients had ICIQ -SF score decreased to 0 points, and the number of patients who decreased to 0 points after 3 months of follow-up increased to 21.
At the beginning of the study, 43 patients used one or more pads per day, with an average of 2.47 ± 2.25 pads per day. After the sixth treatment, a significant improvement of 43.80% (P < 0.001) was observed, with the average number of pads used reduced to 1.35 ± 1.74 per day.
Fifteen (34.88%) of these patients reported that they no longer used the pads, and at 3 months, this had increased to 19 (44.19%) patients. )
(Note 2:
Magnetic stimulation has been used to treat urinary incontinence for many years.
There are also machine models and treatments covered by National Health Insurance in Taiwan.
However. the magnetic field strength generated by the instrument is much weaker than HIFEM and lacks focusing technology.
The difference can be clearly felt when receiving treatment.)
