magnetic field therapy

For a firm pelvic floor and strong sphincter muscle

Treatment in the pulsating magnetic field

Repetitive peripheral magnetic stimulation (rPMS)

Magnetic therapy is a non-invasive, effective approach to treating pelvic floor problems and should be considered for postural weakness (incontinence), decreasing muscle tone and sensitivity disorders.

This therapy, also called Extracorporeal Magnetic Innervation (ExMI), works with magnetic pulses that stimulate the nerve fibres in specific areas of the sacral nerve plexus. Studies showed a significant increase in resting and pinching pressure after treatment.

Advantages of magnetic field stimulation:

  • Noticeable effectiveness in a wide range of applications
  • You remain fully clothed during the treatment
  • You do not need to insert a probe into the anus or vagina
  • The device trains you fully automatically, you don't have to be able to tense the muscle yourself as with pelvic floor exercises.
  • You do not need to deal with technical aspects of operation as with a biofeedback device

Short info video on magnetic field therapy

Magnetic field therapy is a non-invasive procedure based on the physical principle of electromagnetic induction. The magnetic field leads to the triggering of an action potential at the cell membrane. The stimulation takes place through short magnetic pulses that can penetrate tissue without causing pain.

The roots of the sacral nerves S2 to S4 supply the urinary tract, vagina and rectum as well as the muscular pelvic floor vegetatively and somatically.

  • When a motor nerve supplies a muscle, a tension (contraction) of the muscle is triggered. Strength and endurance of the sphincter and pelvic floor are trained by alternating between tension and relaxation.

  • For sensitive nerves, high-frequency stimulation leads to more intensive perception. The regeneration of nerve connections (synapses) is promoted. Desensitisation is achieved with low-frequency stimulation, which can have a positive effect on spasms of the sphincter muscle or frequent urination (hyperactive bladder).

When is magnetic field therapy useful?

Pelvic floor gymnastics, biofeedback, magnetic field therapy

Anatomy and function of the pelvic floor

Three muscle layers form the pelvic floor muscles. They lie on top of each other like a grid and support the organs that lie in the pelvis. In addition, they are of great importance for continence (ability to hold stool and urine).

The inner muscle layer is responsible for the movements of the pelvis, while the middle muscle layer consists mainly of the large perineal muscle. This ensures that the pressure on the basin is absorbed. In women, the perineum muscle is only half as strong as in men. In addition, pregnancy and childbirth are the causes that a significant weakening of the muscle can be observed in about a quarter of all women after menopause. The lowest muscle layer encloses the urethra and anus and, as the sphincter muscle, has the function of enabling rapid contractions.

The pelvic floor, which consists of striated muscles with their voluntary sphincters, and the smooth muscles in the wall of the hollow organs (urethra, vagina, rectum) are exposed to a wide variety of stresses in the course of life.

  • Heavy lifting at work
  • Weight training
  • Deliveries
  • Digestive disorders
  • Sex

Treatment for functional disorders of the pelvic floor

If the stretching of the muscles remains below a certain threshold, the muscle can compensate itself. More stretching leads to structural damage, reduction in strength and also impairment of the nerve supply. The American gynaecologist Arnold Henry Kegel from Hollywood explored the possibilities of actively training the muscles 70 years ago. As a result, pelvic floor therapy has established itself as an independent sub-area of physiotherapy.

It has proven effective to follow a step-by-step scheme for pelvic floor disorders:

  • In the case of incipient and minor complaints, independent exercises can achieve an improvement.
  • If the symptoms increase, treatment and guidance by a specialised physiotherapist is recommended. You can find appropriately trained therapists on the website of the AG GGUP - Gynaecology Obstetrics Urology Proctology working group, among others.
  • Electrostimulation and biofeedback (article to follow)
  • Magneticfield stimulation: Since 1999, magnetic field stimulation has been used in the treatment of functional disorders of the urinary bladder; since 2000, successful applications have been reported for urinary and faecal incontinence (including after childbirth) and impaired coordination of the sphincter muscle, erectile dysfunction due to circulation and vaginal laxity. In a study from Switzerland in 2008, a measurable increase in sphincter pressure and a clinical improvement of faecal retention weakness was found in over 90 % of patients. Further scientific studies have shown that stimulation of these nerves leads to a significant increase in pressure in the rectal and vaginal sphincter. Patients with faecal impaction have been shown to have improved symptoms as measured by the CCIS (Cleveland Clinic Score) and Fecal Incontinence QOL Questionnaire (FIQL). 
  • Sacral nerve stimulation (article to follow)
Banner_Textbooks_of_Proctology

For the treatment of anorectal incontinence, magnetic field therapy is a new procedure whose targeted application can produce good results.

Lange, Mölle, Girona: Chirurgische Proktologie. 2nd edition 2012, Springer Verlag Heidelberg

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Leap13

Easy and comfortable: treatment fully clothed, no insertion of a probe

Repetitive peripheral magnetic stimulation (rPMS): Treatment procedure

We use magnetic field stimulation with the BioCon-2000W™ therapy chair in the following situations:

  • Treatment of incontinence for faeces or intestinal gas
  • Urinary incontinence, especially stress incontinence and incontinence after prostatectomy (specialist urological examination required before starting therapy).
  • Supporting rehabilitation after proctological surgery
  • Support for regression after childbirth
  • Disorders of fine continence in haemorrhoidal disease

The following indications have been less well studied and therefore require particularly careful consideration of benefits:

  • Non-specific pain conditions in the small pelvis
  • sexual dysfunctions

To perform the therapy, you simply have to sit down in the treatment chair. You remain fully clothed and can read a magazine in peace. An electrical system is built into the chair that generates an electromagnetic field and radiates it up to 12 cm deep into the pelvic floor. The frequency and signal strength of the impulses is adjusted by the therapist to suit their indication. During the treatment, the patient feels a sensation as if being "nudged" and/or rhythmic tensions of the muscles to be trained.

You do not have to trigger any activity yourself. This treatment therefore has a chance of success even if one had difficulties feeling and triggering the decisive muscles during pelvic floor exercises or if one was technically unable to cope with a biofeedback device. In a study with patients over 70 years of age, ⅔ of the patients who could no longer do this before magnetic field therapy learned to actively tense the pelvic floor again.

A not inconsiderable advantage of this treatment is that, unlike electrostimulation, no probe has to be inserted into the anus or vagina. We offer 2 treatment sessions of 20 minutes each at one appointment. This means that the treatment is much more successful than the usual treatment of only one 20-minute session.

After two to three treatments, it is usually possible to assess whether the treatment is successful. A treatment cycle consists of 8 - 12 therapy sessions 1 - 2 times per week. As with all sports training, the training success decreases over time. In one study, 75 % of the patients treated were still free of symptoms 14 months after the end of therapy. In any case, it is advisable to continue at least independent pelvic floor exercises afterwards. If the complaints increase again in the future, a new training cycle should be completed at an early stage.

We offer this IGeL service in our proctology practice in Munich. Because we are convinced that you will feel the difference, we offer you a non-binding consultation and a free initial therapy session.

Are there any risks or contraindications?

  • No significant undesirable effects have become known when the product is used as intended.
  • A "muscle ache" after the first treatments is possible and shows the effectiveness of the treatment. We therefore never start with full energy dose.
  • Magnetic data carriers (cheque card, USB stick, SSDs) as well as mobile phones can be damaged if they are in the immediate vicinity of the magnetic field.
  • Unfortunately, the treatment cannot be carried out on ferromagnetic or electrical implants (orthopaedic implants for which no detailed information about the material composition is known, pacemakers, defibrillators, insulin pumps or similar).

And finally the evidence again

Bibliography Magnetic field therapy of the pelvic floor

Anderson, C. A., Omar, M. I., Campbell, S. E., Hunter, K. F., Cody, J. D., & Glazener, C. M. (2015). Conservative management for postprostatectomy urinary incontinence. The Cochrane database of systematic reviews, 1(1), CD001843. 

Benezech, A., Bouvier, M., & Vitton, V. (2016). Faecal incontinence: Current knowledges and perspectives. World journal of gastrointestinal pathophysiology, 7(1), 59-71.

Brusciano, L., Gambardella, C., Gualtieri, G., Terracciano, G., Tolone, S., Schiano di Visconte, M., Grossi, U., Del Genio, G., & Docimo, L. (2020). Effects of Extracorporeal Magnetic Stimulation in Fecal Incontinence. Open medicine (Warsaw, Poland), 15, 57-64. 

Galloway, N. T., El-Galley, R. E., Sand, P. K., Appell, R. A., Russell, H. W., & Carlan, S. J. (1999). Extracorporeal magnetic innervation therapy for stress urinary incontinence. Urology, 53(6), 1108-1111.

Gumussoy, S., Kavlak, O., & Yeniel, A. (2021). Effects of Biofeedback-Guided Pelvic Floor Muscle Training With and Without Extracorporeal Magnetic Innervation Therapy on Stress Incontinence. "Journal of Wound, Ostomy & Continence Nursing, 48(2), 153-161.

Hou, W. H., Lin, P. C., Lee, P. H., Wu, J. C., Tai, T. E., & Chen, S. R.. (2020). Effects of extracorporeal magnetic stimulation on urinary incontinence: A systematic review and meta-analysis. Journal of advanced nursing, 76(9), 2286-2298. 

Hoyte, L. (2007). A Pilot Study of Extracorporeal Magnetic Stimulation of the Pelvic Floor for the Treatment of Women With Fecal Incontinence and Underactive Pelvic Floor Muscles. Journal of Pelvic Medicine and Surgery, 13(1), 19-26.

Ishikawa, N., Suda, S., Sasaki, T., Yamanishi, T., Hosaka, H., Yasuda, K., & Ito, H. (2006). Development of a non-invasive treatment system for urinary incontinence using a functional continuous magnetic stimulator (FCMS). Medical & Biological Engineering & Computing, 36(6), 704-710.

Kirschner-Hermanns, R., & Jakse, G. (2007). Magnetic stimulation of the pelvic floor in the elderly. Results of a prospective analysis [Magnetic stimulation of the pelvic floor in older patients. Results of a prospective analysis]. The Urologist. A, 46(4), 377-381.

Kegel, A. (1949). Progressive resistance exercise in the functional restoration of the perineal muscles. Obstetrical & Gynecological Survey, 4(1), 154-154.

Lim, R., Liong, M. L., Leong, W. S., Karim Khan, N. A., & Yuen, K. H. (2017). Pulsed magnetic stimulation for stress urinary incontinence: 1-year follow-up results. The Journal of Urology, 197(5), 1302-1308.

Lim, R., Liong, M. L., Lau, Y. K., Leong, W. S., Khan, N., & Yuen, K. H. (2018). Effect of Pulsed Magnetic Stimulation on Sexual Function in Couples With Female Stress Urinary Incontinence Partners. Journal of sex & marital therapy, 44(3), 260-268.

Morren, G. L., Walter, S., Hallböök, O., & Sjödahl, R. (2001). Effects of magnetic sacral root stimulation on anorectal pressure and volume. Diseases of the colon and rectum, 44(12), 1827-1833.

Quek P. (2005). A critical review on magnetic stimulation: what is its role in the management of pelvic floor disorders?. Current opinion in Urology, 15(4), 231-235.

Sand, P. (2000). Electromagnetic Pelvic Floor Stimulation: Applications for the Gynecologist. Obstetrical & Gynecological Survey, 55(11), 715-720.

Shafik, A. (2009). Treatment of fecal and urinary incontinent patients by functional magnetic stimulation of the pudendal nerve. coloproctology, 21(2), 45-49.

Sun, K., Zhang, D., Wu, G., Wang, T., Wu, J., Ren, H., & Cui, Y. (2021). Efficacy of magnetic stimulation for female stress urinary incontinence: a meta-analysis. Therapeutic advances in urology, 13, 17562872211032485.

Thornton, M. J., Kennedy, M. L., & Lubowski, D. Z. (2005). Extracorporeal magnetic stimulation of the pelvic floor: impact on anorectal function and physiology. A pilot study. Diseases of the colon and rectum, 48(10), 1945-1950.

Voorham-Van der Zalm, P., Pelger, R., Stiggelbout, A., Elzevier, H., & Lycklama á Nijeholt, G. (2006). Effects of magnetic stimulation in the treatment of pelvic floor dysfunction. BJU International, 97(5), 1035-1038.

Forest A. (2018). Diagnosis and Management of Fecal Incontinence. Current gastroenterology reports, 20(3), 9.

Weber-Rajek, M., Radziminska, A., Straczynska, A., Podhorecka, M., Kozakiewicz, M., Perkowski, R., Jarzemski, P., Kedziora-Kornatowska, K., & Goch, A. (2018). A randomized-controlled trial pilot study examining the effect of extracorporeal magnetic innervation in the treatment of stress urinary incontinence in women. Clinical interventions in aging, 13, 2473-2480. 

Yamanishi, T., Yasuda, K., Suda, S., Ishikawa, N., Sakakibara, R., & Hattori, T. (2000). Effect of functional continuous magnetic stimulation for urinary incontinence. The Journal of Urology, 163(2), 456-459.

DR. BERNHARD HOFER & COLLEAGUES

Specialists in surgery, proctology

Brienner Str. 13, D-80333 Munich, Germany

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