Urogynecological stimulant MEM
Justification of the method
MEMS device designed for the treatment of inflammatory diseases of the female genital tract,
primarily the recovery of muscle volume, muscle tone, activity of the neuromuscular system,
caused by prolonged physical inactivity and malnutrition muscles reproductive system of women.
The problem of venous stasis women is the cause of many diseases.
One of the causes of venous stasis is dissatisfaction with the sexual acts that may cause mastitis,
uterine fibroids, cancers: uterine, ovarian and breast cancer.
One of the most significant physiological causes disharmony of sexual relations is the
weakening of muscles of the vagina, which are involved in the stimulation of the G-spot,
responsible for the orgasm, so the effectiveness of treatment depends primarily
on training the bosom-coccygeal muscles. Prevention and elimination of venous stasis electro-stimulation influence can restore sexual sensitivity and increase the likelihood of sexual satisfaction,
Electrical stimulation of the penis improves blood circulation and increases its sensitivity.
Train the pelvic floor muscles to prevent the disease, facing one third of women
aged over 40 years: involuntary urination when coughing, uterine prolapse and rectum.
The efficiency of the method depends on the choice of the optimum current pulse parameters: form,
duration, repetition frequency, which do not cause side effects and discomfort of patients.
The phone has two modes of MEMS electrical allowing locally affect the body (vaginal) and subsequently to its projection (Clitheroe, ureter, vaginal wall, cervix).
In addition to the electrical device MEM has the following modes: photic, photic stimulation in conjunction with electrical stimulation, pneumomassage with electrostimulation.
Full text of the guidelines can be purchased at our Centre APPAMED
Complex method of treatment of patients with non-withholding of urine, chronic pelvic pain syndrome and in violation of the orgasm
with the help of photos, pneumatic and electrical.
Introduction.
Search treatments and non-withholding of urinary incontinence (incontinence), chronic recurrent cystitis, pollakiuria,
chronic pelvic pain syndrome, disturbances in achieving orgasm is an actual medical problem.
The weakening of general and local reactions of the organism as a result of exposure to environmental factors,
systematic stress situational tension and various psychological fears plays an important role in the development of these diseases.
Among the factors that contributes to the occurrence of these diseases include: heredity, overcooling, sedentary lifestyle,
sexually transmitted infections, prolonged abstinence, the use for the purpose of contraception coitus interruptus, etc.
One of the causes of symptomatic non-withholding of urine, chronic pelvic pain syndrome,
disturbances in achieving orgasm is to reduce the tone of the pelvic floor muscles and,
as its consequence, the omission of the pelvic organs (vagina, uterus, bladder, rectum).
Reduced tone of the pelvic floor muscles, observed after childbirth, surgery,
and is a negative factor in the ability to control the muscles controlled this area.
Muscles of the pelvic region defined significant role in sexuality.
There are a number of scientific research, which clearly traced a pattern in reaching orgasm during sexual intercourse, provided trained,
strong pelvic muscles in women. It allows a woman to feel the climax of orgasm.
More developed pelvic muscles also contribute to the prevention of urinary disorders.
About 30% of women after the age of 35-40 years suffer from varying degrees of severity of non-withholding of urine
at a voltage of the anterior abdominal wall when you laugh, cough, sneeze.
With age, the number of women suffering from this dysfunction increases, muscles of the pelvic floor loses its tone
and the presence of precipitating factors is a weakening of the muscles, directly covering the urethra, which is manifested
by involuntary urine withhold. Reduced muscle tone after birth leads to the omission of the pelvic organs is primarily
due to the weakening of the ligamentous apparatus of the internal genitalia and bladder.
As a result of reduced muscle tone occur stagnation of venous blood flow in the pelvic organs,
which is a pathogenic mechanism of chronic pelvic pain syndrome, female sexual dysfunction and dyspareunia.
The central problem of female sexuality are violations in achieving orgasm, as a manifestation of the most severe forms
of sexual dysfunction in women. According to the results of large-scale studies conducted in recent years in Europe,
the USA, Australia, one in four women do not experience orgasm, 30% experience it rarely, 20% do not know anything about orgasm.
For each age period of a woman's life state of sexual comfort associated with the achievement of the psycho-emotional harmony,
stability, physical and somatic indicators of hormonal homeostasis.
Undoubtedly, any disturbances in the complex relationships of the female body, with age-appropriate have a direct impact on the quality of life
and require adequate correction.
Guidelines are developed based on the results of clinical observations at the Ukrainian Institute for Sexology
and Andrology at the medical center and the new CMD urogynecological stimulator MEM.
Guidelines are intended to inform the obstetrician-gynecologists, sexologists, Urologists, physical therapists, family physicians,
medical interns about modern methods of treatment of non-withholding of urine, chronic pelvic pain syndrome, disturbances in achieving orgasm.
Biophysical basics of exposure to electrical, laser and pnevmostimulyatsii in the treatment of non-withholding of urine syndrome,
chronic pelvic pain and disorders in achieving orgasm.
Pelvic floor musculature is represented superficial, medium and deep layers.
The muscular cleft placed the vagina, the external opening of the urethra and the external sphincter of the rectum.
The pelvic floor bears a support function and is responsible for the topography of the internal genital organs, bladder, and rectum.
Between the coccyx and the pubic bone is the bosom-coccygeal group of muscle fibers (musculus pubococcygeus),
consisting of 70% -95% of slow and fast fibers.
Upon excitation of the total diameter of the trained muscles can grow up to 40 millimeters
In women, perhaps unconscious contraction of the muscle, in the presence of exciting visual effects.
Trained pelvic floor muscles provide stability to achieve the topography of the pelvic organs, which is an obstacle to the descent
and prolapse of the uterus, rectum and withhold involuntary urine during physical exertion.
For example, women in India rarely suffer this pathology, since traditionally carry gravity, drawing on his head for a long time
sitting on his haunches, due to the lack of tables used in the household use of European countries,
and it provides them with training muscles of the neck, back, pelvic floor and, in particular, the fold of the PC muscle.
Since the pelvic musculature associated with the abdominal muscles, back, aperture, outer muscles of the pelvic region,
their training also leads to strengthening of the muscular system of the region, and provides holding posture and slim figure.
In order to achieve harmony of sexual relations is also important exercise vaginal muscles
and pelvic floor to relax the vaginal phase took place without disturbing the harmony of sexual intercourse.
During intercourse comes effect "losses" of the penis, which consists in the fact that a woman at a stage of sexual arousal vagina elongated by 30%,
is expanded to 2/3 of its volume, which allows the formation of so-called vaginal frame.
At the same partner for this period does not feel the vaginal walls.
If you have a normal tone of the pelvic floor muscles this effect is faster, provided natrenirovannosti bosom-PC muscl
and the growing excitement in women. Otherwise, in this phase, sexual intercourse, may disrupt the harmony of sexual contact,
causing the suspension of intercourse and sexual disharmony couples.
Increased muscle mass and enhance their sensitivity may be achieved by mechanical or electro-stimulation
. Examples of mechanical stimulation is a set of exercises on the use of vaginal or Kegel exerciser C.O.M.E ..
According to the, the ancient Chinese treatise strengthen the vaginal muscles can be achieved by drawing the
anus muscle tension of the pelvic floor muscles. Complex Kegel exercises should be carried out for an hour a day,
and include rapid alternation to 60 beats per minute, and slow contractions constrictor muscles stop urination process,
compression of the external sphincter of the rectum and vagina muscles for 5 minutes, 3 times a day.
Train the pelvic floor muscles can be carried out using C.O.M.E. simulator representing an approximation as
an elastic rubber bulb with a single control indicator. The advantage of the device in a simple design and availability of training method.
The essence of the method lies in the bosom of the training, the PC muscle by periodic efforts to compression.
Mechanical methods are simple. However, labor input and long-term training in their use reduces the effectiveness of the stimulation.
With electro-stimulation training synchrony and speed of contraction and relaxation of the bosom, the PC muscle is stabilized
by selective choice of the frequency and amplitude of stimulation over a wide range.
Electrical stimulation can be used in the treatment of muscle wasting, and urinary incontinence withhold, in order to stimulate
the external sphincter of the rectum after operations on the pelvic organs to strengthen the muscles,
with one-sided paralysis of the muscles (hemiplegia).
Prevention of venous stasis in the pelvic organs influence of electro-stimulation helps to normalize blood flow
and achieve a therapeutic effect at a syndrome of chronic pelvic pain, dyspareunia, sexual dysfunction in women.
The efficiency of the method depends on the choice of the optimum current pulse parameters: form, duration,
repetition frequency, which do not cause side effects and discomfort for patients.
Short- rhythmic electrical currents excite conductors myelinated nerve somatosensory systems
(skin, mucous membranes and muscle afferents) belonging to the beta-fibers leading to increased afferent flow therein.
It is known that skin nerve guides have maximum sensitivity to these currents.
Emerging rhythmic ascending afferent flows from the thick myelinated fibers are distributed toward the gelatinous substance
of spinal cord neurons excite her. As a result of what is happening with the presynaptic inhibition in lateral horns
of the spinal cord reduced the allocation of substance P and decreases the likelihood of transmission of impulses
from the afferent conductors of pain sensitivity (Aδ- and C-fibers) neurons in the reticular formation and supraspinal structures.
In addition, the excitation of interneurons posterior horn of the spinal cord leads to the release of opioid peptides in them.
"Rhythmic stimulation" under the law backward induction delocalisation causes pain in the cortex of the dominant centers
and activates the parasympathetic nervous system.
The activation of serotonin release in the ventral midbrain lateral system kernels and peptidergic system ventral hypothalamus.
Activation of the physiological mechanisms of descending pain suppression leads to a reduction of pain until complete analgesia.
The number of active anastomosis and collaterals mikrotsirkulyatsionnogo channel and speed of blood flow in the affected organs and tissues,
activates trophic influence of the sympathetic nervous system and improve the local immune mechanisms of protection.
Increased venous return, stimulated by dehydration of tissues, their swelling decreases.
There activation edorfinov production, enzymes, utilizing algogenic mediators (acetylcholinesterase and histaminase)
and biologically active compounds (kininase).
Thus, the pulse currents have important therapeutic effects: mioneyrostimuliruyuschim, analgesic, local vasoactive, local neurotrophic.
These effects are most pronounced when electric pulse impact on the paravertebral area and the area of the reflected pain,
arising from the diseases of certain organs (Zakharyin-Ged zone).
Such areas are known to be formed as a result of the convergence of somatosensory and viscerosensory afferent fibers
to the neurons of the dorsal horn of the spinal cord that is at the heart of one of the pathogenic mechanisms leading
to the development of symptoms of "chronic pelvic pain syndrome," female sexual dysfunction, dyspareunia.
Energy lasers and incoherent light are widely used in many fields of medicine.
One of novel therapeutic devices for the treatment of a Electrolaser unit MEM.
The use of this machine allows you to work on various parts of the pathogenetic mechanisms in withhold urine,
chronic pelvic pain syndrome, and disturbances in achieving orgasm. This is achieved through the use of photic stimulation.
Using the techniques presented can achieve normalization of blood and limfootoka, improve the rheological properties of blood,
stimulate the synthesis of ATP, providing anti-inflammatory, regenerative, analgesic, anti-inflammatory,
desensitizing, immunomodulatory, neurotrophic effects
In addition to electrical stimulation and laser light to directly impact on the G-spot, which is responsible to the vaginal orgasm,
used pnevmovibratsiya.
Polysystemic pathological process dictates the need for an integrated use of natural therapeutic factors: in the combined
and combined forms. Combined treatment involves the simultaneous effect on the lesion by several physical factors.
In the combined treatment they are used either simultaneously or sequentially with the various time intervals.
The high efficiency of complex influence of physical factors properly selected based on their synergies, the manifestation of new therapeutic effects,
as well as increasing the duration of physiotherapy aftereffects.
Inform: urogynecological developed MEMS device, the appearance of which is shown in Fig. 1.
Figure 1 urogynecological stimulant MEMS device MEM is designed to treat dyspareunia at a syndrome of chronic pelvic pain in women,
violations in reaching orgasm and, above all, to restore muscle volume, muscle tone, activity of the neuromuscular system,
caused by prolonged physical inactivity and malnutrition pelvic muscles bottom.
The main technical parameters of the MEMS device are shown in Table 1
Table №1
Technical parameters Units
Pressure pulse repetition period PE, p. 0.8
Limits of adjustment pressure in PE, kPa 10 - 40
Duration of bipolar rectangular pulses, ms. 100
The duration of the burst, ms. 2
The duration of pauses between pulses of 100 microseconds
The repetition period of bursts, c 0.8; 0.2; 0.05
The duration of the cyclic repetition of a set of packs:
* - 1 electrical mode with
** - Electrical mode 2, with
60
4
current pulses at a load of 200 ohms ± 1% A (2.0 - 200) ± 10%
Wavelength photic stimulation (red), 620 nm
The radiation power during photic stimulation (red) 5 mW
Wavelength photic stimulation (blue), 470 nm
The radiation power of photic stimulation (blue) mW. 7
The wavelength of red continuous laser nm. 658
Power continuous red laser mW 5, 10, 15, 20, 25 and 30 ± 10%.
The wavelength of infrared pulsed laser 850 nm
Power infrared laser pulse, W 10 ± 20%.
The duration of the pulse of infrared laser pulse, 150 ns.
The pulse repetition frequency of the infrared laser Hz. 50, 100, 250, 500, 1000, 2000 and 3000
Note*
Urogynecological MEMS device provides the following stimulation modes: - urethral electrical stimulation is performed
by introducing into the urethra single ended (UE1) or double contact (UE2) endouretralnye electrodes (Figure 4)
Figure 4 An one-and two-contact electrodes UE1 and UE2.
Single ended and double-ended applicators UE1, UE2, are used in electro-muscle region of the urethra and bladder neck.
The form of abdominal electrodes is ideal for the treatment of diseases of the genitourinary system,
including non-withholding and urinary incontinence
. When using UE1 electrode as the second electrode is used indifferent electrode EI, shown in Figure 5.
Depending on the task the impact on different groups of muscles indifferent electrode located above the vagina,
in the perineum or over the patient's sacrum.
Figure 5 indifferent electrode NE
When using UE2 instead indifferent electrode connects the second contact of the applicator.
This connection is provided by electrical stimulation of muscles of the urethra and clitoral tissue.
- Transrectal and transvaginal electrical stimulation is performed using the four-contact applicator CHA.
In this mode, stimulation is achieved by selectively connecting one of the four electrodes of the applicator to the device,
to influence the most sensitive vaginal areas (vagina, vaginal wall, the point G), and cervix, as well as patch-type "wave",
which provides a consistent electrical stimulation said regions.
Figure 6 A four-Cha applicator and applicator of the "wave" of the cervix
and Electrical pnevmovibratsionny massage the G-spot is provided c pnevmoelektrostimulyatsionnogo applicator PE (Figure 7).
Before the procedure, the applicator electrode and the indifferent electrode is connected to the device using
an electrical connector and simultaneous connection of duct to the nozzle applicator.
Figure 7 Pnevmoelektrostimulyatsionny applicator PE
Spherical electrode applicator in electrical contact with the cervix.
On the surface of the cylindrical rod is provided a gap length of 4 cm, through which is blown rhythmically vibrating wall rubber fingertip.
At the session of the applicator slot is focused on a point Grafenberg (G-point).
In order to ensure sterility of the procedure applicator condom is stretched and fixed spherical top electrode by piercing the condom,
followed by sealing the electrode clamp.
Photic stimulation in red and blue spectra together with the electrical stimulation is performed by one
of the applicators FE1, FE2. FE1 applicator wavelength corresponding to the maximum spectral density is 0.6 microns, but for FE2 - 0.4 microns. (Figure 8).
Figure 8 Photovoltaic applicators FE1 and FE2.
The combination of photo and electrostimulation provides a synergistic effect on the muscles
and nerves of the vagina and rectum. In order to ensure sterility of the procedure on the applicator as in the case of a
condom applicator PE tensioned and secured by piercing electrode spheroidal apex condom followed by sealing by pressing the electrode
applicator to the top FE1.
Indifferent electrodes are washed in water and sterilized in 70% alcohol solution.
A method of sterilizing chemical other electrodes.
To eliminate the influence of sudden changes in voltage at the electrical necessarily need to use stable
sources of uninterrupted power supply UPS type.
Indications for therapeutic methods.
- Chronic inflammatory diseases of the pelvic organs with pain - a syndrome and a disorder of the venous and arterial circulation.
- Withhold and incontinence.
- Chronic recurrent cystitis.
- Reduction of neuromuscular excitability of the pelvic floor muscles.
-To Restore normotonusa pelvic muscles in the late postpartum period.
- Sexual dysfunction in women, including failure to achieve an orgasm.
- Dyspareunia.
Contraindications to medical techniques.
- Malignant processes.
- Diseases of the hematopoietic system.
- Inflammatory diseases of the pelvic organs in the acute stage.
- The acute phase of infectious diseases.
- Tuberculosis.
- Hypertensive heart disease III stage.
- Acute circulatory disorders.
- Acute and chronic blood loss.
- Organic pathology of the central nervous system.
- Mental disorders.
Rationale for the use of methods of treatment of chronic diseases of the urogenital tract of women,
aimed at restoring the activity of the neuromuscular system during inactivity and malnutrition pelvic muscles, failure to achieve an orgasm.
In order to avoid inappropriate responses of the organism to physical therapy action appropriate to begin a course
of treatment for 5-7-th day of the menstrual cycle in women of reproductive age.
it is desirable to carry out the procedure on a daily basis, since the appointment of a day reduced the effectiveness of the treatment.
In assessing the effectiveness of physiotherapy course it is important to take into account the particular period
of its aftereffects - for 4-6, at least 8 weeks after the procedure is completed.
For myostimulation pulses applied sinusoidal, rectangular and triangular shapes, which do not cause usually discomfort. When using a pulse action on the body is reduced heat generation and reduced load on the cardiovascular and nervous systems.
It is known that the optimal frequency of pulses for myostimulation 2,5kGts for neurostimulation - 4 kHz.
The modulation frequency electrical stimulation at striated muscle pelvis and perineum is usually chosen in the range of physiological rhythms - 1-2Gts.
For the smooth muscle of the rectum, bladder and vagina frequency is 5-6Gts.
To improve the trophic nerve endings to achieve analgesia used frequency electrical 18-21Gts.
Compliance with the modulation mode prevents the possible adaptation of the organism to the ongoing electrical stimulation.
At frequencies 35Hz (300ms) do not experience muscle fatigue, a high frequency is more
comfortable as compared to the low frequency.
If you experience any discomfort, the patient should reduce the amplitude of the current pulses.
For each patient the current thresholds have individual character.
And at long exposures observed effects of the body getting used to the irritation, so during the current procedure can be increased,
taking into account the feelings of the patient. When you select the exposure time of the muscle relaxant should be two times longer than the time of their excitation.
To stimulate the G- point pnevmovibratsionny selected mode with a frequency of vibration 1,2Gts,
since the frequency of uncontrolled fluctuations bosom-PC muscle that occur during orgasm, up 1.25 Hz.
The maximum pressure amplitude selected in the range of 10 kPa - 40kPa, depending on the patient's health.
Conducting electro-fold of the PC muscle and pneumovibromassage point-G urogynecological carried out on a chair in half upright position,
allowing you to relax the muscles of the lower half of the body.
Since the point of stimulation-G there is the urge to urinate, the patient should be advised of the procedure to empty the bladder.
The effectiveness of the procedure is ensured complete relaxation of the patient.
Your doctor may choose one of three methods:
- Passive - without the active participation of the patient,
-samostoyatelnuyu when the patient actively reduces perineal muscles with the beginning of the procedure,
- The complex when the doctor in order to improve muscle tone produces a slight manual pressure on the perineal tissues.
Applicators should be warmed before use, down to pre-warm sterile solution furatsilina 1: 5,000 and plentifully greased with Vaseline.
During the procedure, you must provide a reliable contact with the indifferent electrode bosom,
crotch or sacrum using the tool in the form of sterilized pads with sand, or by pressing the electrode hand in rubber glove.
Reliable contact of the electrodes with the body is important because at the moment of contact of the patient
may experience loss of "throw" of current. Although the MEMS device provides protection from the "surge" current on and off the device, however, you must pay attention to ensure reliable contact.
Procedures are conducted daily in the absence of discomfort during urination.
Urethral electrostimulation may alternate with rectal procedures.
The average duration of the procedure 15 - 20 minutes.
The number of procedures 15-20.
After the patient is recommended to urinate procedure.
When the duration of the course of treatment up to 4 weeks, an increase in muscle mass,
the stabilization of synchronization pulse excitation and speed reduction reaction.
By eliminating the FSD is important to remember that in the process of sexual arousal involving subcortical and cortical centers,
the peripheral parts of the nervous system, blood vessels, pelvic organs.
Because important relevant training to therapy.
The visual and audio information (erotic videos, music) can be used as a positive additional stimulus during training.
Before starting treatment sessions carefully read with the passport urogynecological simulator "MEM".
Methods of application photo, pneumatic and electrical stimulation in the treatment of disorders in achieving orgasm.
Procedure: 1. Phototherapy and electrostimulation.
Used photoelectric applicator FE1 or FE2, photostimulation is carried in red and blue spectra of the walls of the vagina
and G-spot simultaneously with electrical stimulation of the cervix, the walls of the upper third of the vagina and paravaginalnyh muscles.
Indifferent electrode located on the rump with a gauze pad soaked in warm 0.9% sodium chloride solution for close contact with the skin
.
Select works "ELECTROSTIMULATION - EF" mode.
When setting the parameter values for the first treatment is recommended to start with 2 electrical mode with the
duration of the cyclic exposure of 4 seconds - the intensity of photic stimulation with 20-40% - the duration of the procedure
starting from 10 to 20 minutes. Particular attention should be given to installing the current pulses.
Once the START doctor slowly increases the amount of current by controlling the patient's sensation.
In the absence of side effects, each of the indicators can be increased in subsequent procedures.
Methodology 2. Electrical stimulation using a four-contact applicator CHA and applicator of the "WAVE".
For the stimulation of certain areas of the vagina is selected A four-Cha applicator or the applicator "WAVE".
Indifferent electrode located on the rump with a gauze pad soaked in warm 0.9% sodium chloride solution for close contact with the skin
Electrical stimulation is performed with a duration of the cyclic exposure setting mode 2.
When pulse current values during the first procedure is recommended to choose depending on the nature of the patient's sensations,
ranging from mild tingling to and preventing pain.
Exposure therapy treatments start with a 10 to 30 minutes. In subsequent procedures,
the current value can be increased (in the absence of side effects).
Methodology 3. Pnevmoelektrostimulyatsiya.
Used pnevmoelektrostimulyatsionny applicator PE, indifferent electrode located on the rump with a gauze pad soaked
in warm 0.9% sodium chloride solution for close contact with the skin.
When setting the parameter values for the first treatment is recommended to start with 2 electrical mode with
a duration of 4 seconds exposure to cyclical pressure control in pnevmoapplikatore PA start with 10-20 psi, raising
his agreement with the patient to 40 kPa exposition procedures begin with 10 to 30 minutes.
Methodology 4. Electrical stimulation at withhold and incontinence, chronic recurrent cystitis.
For the urethral stimulation using single-contact (UE1) or two-contact (UE2) endouretralnye electrodes.
Indifferent electrode located above the pubis with a gauze pad soaked in warm 0.9% sodium chloride solution for close contact with the skin is fixed sandbags.
Electrical stimulation is performed with a duration of the cyclic exposure mode 1.
When setting values of the pulse current during the first procedure is recommended to choose depending on the nature of the patient's sensations
, ranging from mild tingling to and preventing pain. Exposure therapy treatments start from 15 to 30 minutes.
In subsequent procedures, the current value can be increased (in the absence of side effects).
Methodology 5. Electrical stimulation for chronic inflammatory diseases of the pelvic pain syndrome
and a disorder of the venous and arterial circulation (chronic pelvic pain syndrome) during rehabilitation, dyspareunia.
Use four-electrode applicator for vaginal stimulation, indifferent electrode located on the rump with a gauze
pad soaked in warm 0.9% sodium chloride solution for close contact electrode recorded the patient's body.
Electrical stimulation is performed with a duration of the cyclic exposure mode 1 When pulse current values during the
first procedure is recommended to choose depending on the nature of the patient's sensations, ranging from mild tingling to and preventing pain.
Exposure therapy treatments start from 15 to 30 minutes.
In subsequent procedures, the current value can be increased (in the absence of side effects).
Methodology 6. Electrical stimulation to strengthen muscle while reducing the neuromuscular excitability,
and rebuilding normotonusa muscles of the pelvic floor in the late postpartum period.
A four-applicator is used to stimulate the vagina, indifferent electrode located on the perineum with gauze pads
soaked in warm 0.9% sodium chloride for a close contact with a solution,
the electrode is fixed patient's hand or a health care professional in a glove.
Electrical stimulation is performed with a duration of the cyclic impact in mode 1,
when installing the pulse current values during the first procedure is recommended to choose depending on the nature
of the patient's sensations, ranging from mild tingling to and preventing pain.
Exposure therapy treatments start from 15 to 30 minutes.
In subsequent procedures, the current value can be increased (in the absence of side effects).
The results of clinical application of techniques for violations in achieving orgasm.
The presented methodology as for therapeutic and prophylactic purposes were approved in the Ukrainian Institute for Sexology
and Andrology and Medical Center of Molecular Diagnostics.
Materials and methods. We carried out a survey in the dynamics of observation (6 months) before and after treatment
in 30 women aged 25 to 48 years with a duration of sexual intercourse from 3 to 29 years with disabilities in achieving orgasm.
At the same time the primary violations occurred in 11 (36.67%) and secondary -19 (63.33%) patients.
Using the questionnaire in different versions (interview survey, filling daily journal or diary event registration)
provides information about the features of sexual health examinees and the source of disturbances in achieving orgasm.
It should be noted that during the interview-polls were taken into account unforeseen adverse circumstances and events,
detailed the key points arising sexual disorders.
At the same time the day before the study and after 1-3 months after its completion we evaluated the degree of coincidence
filling ctw erogenous zones as described in partners VI Zdravomyslova.
Studying achieve adequate sexual arousal in women taking into account the vascular changes was performed using ultrasound
Doppler method to XARIA TOSHIBA apparatus before and after the end of the prescribed course of physiotherapy.
Determination of the sensitivity of the erogenous zones of the first order,
before and after treatment was carried out by vibrotestirovaniya.
Evaluation indicators of sexual health is also carried out using the method of pH measuring vaginal mucosa before
and after 15-20 minutes after the sexual stimulation.
In assessing the pH of the vaginal mucosa with our patients, we used vidioeroticheskuyu stimulating
and exciting lubricant with aphrodisiacs, before and after the end of the prescribed course of physiotherapy.
After the course of examination and determination of objective indicators of women's sexual health,
we have appointed a course of physical therapy with the inclusion of photo-pneumatic and electro.
Preliminary studies have shown that it is appropriate to appoint the presented methods in stages, the sequence of courses.
In the first stage of therapy to treat using fotoelektrostimulyatsii - 11-17 procedures.
At the second stage - to use electrical stimulation via CHA and the "Wave" electrode - 11-17 procedures.
And on the third (final) stage of therapy - to conduct pnevmoelektrostimulyatsiyu - 11-17 procedures.
All of the above procedures starting to spend every day after menstruation.
During menstruation, the procedure carried out is contraindicated.
Women in menopause should be observed phasing and sequencing of procedures.
The interval between each treatment step should be from 7 to 10 days.
The results of observations.
In the analysis of the survey results using the methods of questioning and interview survey completed by patients daily diaries
and event log diaries found that disturbances in orgasm in women was the cause of disharmony sexual couples in 17 (56.67%) cases.
The majority of women surveyed did not consider it necessary to seek specialized help the sexual.
Problems of sexual relations they connected with indelicate husband 7 (23.33%), long stereotyped connections 5 (16.67%),
interpersonal conflicts 5 (16.67%). Of these, 24 (80.0%) women would like to have intercourse more often,
26 (86.67%) noted a lack of foreplay before intercourse, 24 (80.0%), dissatisfaction with sexual intimacy.
Upon completion of the course of treatment we have developed positive clinical relationship has been noted in the study
of sexual health indicators, as 63.33% of the patients noted a change in the stereotype, not only in intimate relationships, but also the family.
In this case 16 (56.67%) women began to show sexual activity with a change in the nature of sexual intercourse foreplay,
14 (46.67%) of respondents noted increase in the number of sexual contacts per week,
the average rate which was 4.23 times (at a frequency of sexual contacts before treatment - 3.61),
an increase of gratification (a positive reaction to the woman's sexual foreplay) - 10 (33.33%),
increase in the degree of sexual satisfaction - 12 (40.0%), achieving an orgasm - 7 (23.33% )
and as a consequence of all the above listed normalization harmony of sexual relations was observed in 17 (56.67%) of couples.
In confirmation of what has been said above it should be noted that at the same time
and independent filling cards erogenous zones of men and women before treatment, marked the erogenous
zones of the first and the second order is not matched in 19 (63.3%) cases, which confirmed the lack of mutual trust
and intimate sexual interest partners to each other. Upon completion of the course of complex treatment with the use of photo-pneumatic and electro, the figure was 14 (46.67%).
During the Doppler found that the rate of blood flow volume genitalia (clitoris) using Doppler ultrasound in women
prior to the combined treatment was 1.8-2.9 cm / sec at rest and 2,3-2,8sm / sec - after 15-20 minutes
after video erotic stimulation with the local use of lubricants containing aphrodisiac.
We have seen that to the prescribed treatment, these figures were lower than normal level (2.0-4.0 cm / s and 4.0-8.0 cm / sec, respectively).
After the end of treatment (3rd stage) in 18 (60.0%) patients the rate of blood flow clitoral blood vessels improved and remained stable.
The rate of blood flow at rest ranged from 2.0 to 3.9 cm / sec, and after stimulation of 3.5 to 7.5 cm / sec, which indicates
an improvement in the response of the vascular response to sexual stimuli genitals against the backdrop of an adequate stimulation.
During the vibrotestirovaniya it found that the threshold sensitivity of the erogenous zones of the first order before
the start of treatment had higher thresholds.
According to the results at the end of the course vibrotestirovaniya physiotherapy improving proprioceptive sensitivity
of the first order of erogenous zones by reducing the threshold levels as a direct proof
of the neurogenic improve sexual response level for violations in achieving orgasm and sexual disharmony marriage.
When studying women vaginal mucosa pH to the destination rate physiotherapy this figure alone was
in the range of 4.1 to 4.5 and from 5.5 to 6.5 - after stimulation.
The normal pH of the vaginal mucosa in women of reproductive age before stimulation is in the range 3.8 to 4.2 and is increased
after stimulation to 7.8
. At the end of the phased physiotherapy treatment in 20 (66.67%) patients during the pH measuring vaginal mucous
normalization of these indicators has been identified from 3.9 to 4.3 at rest and to 7.4 after the appropriate stimulation.
Analysis of the results. Restoring harmony of sexual relations and orgasm occurred in 5 (45.45%) women with primary
and in 12 (63.15%) - with secondary disabilities in achieving orgasm.
In our view, the achievement of positive results of treatment in 56.67% of women with disabilities in reaching orgasm due to
a rational approach in justifying gradual physiotherapy techniques including photo, pneumatic and electrical stimulation.
The results of clinical application of techniques in non-withholding and incontinence, chronic recurrent cystitis.
Objective: To evaluate the efficiency of photo-pneumatic and electro while eliminating non-withholding and urinary incontinence,
chronic recurrent cystitis.
Materials and methods. We carried out a survey in the dynamics of observation (at least 12 months) before
and after treatment of 183 women aged 23 to 48 years with disease duration from 1 to 7 years.
At the same time the symptoms of non-withholding of urine occurred in 127 (69.4%)
and incontinence - 56 (30.6%) patients.
Danae symptoms urodynamics disorders occurred in 124 (67.76%) women with chronic recurrent cystitis.
After the course of examination and determination of objective indicators of violations of urodynamics,
we administered a course of physical therapy with the inclusion of a photo session, pneumatic and electrical.
At the beginning of the session based on the methodology 1, 4 and then the method terminates the session holding method 3.
The criterion for clinical efficacy, we thought remission urodynamic disorders
. Upon completion of a course of therapy during remission was observed up to 6 months 56 (44,09%) patients
and to withhold the urine in 21 (37.5%) with incontinence, and 12 months - 53 (41.73%) and 31 (55 , 35%),
and more than 12 months - 18 (14.17%) and 4 (7.14%), respectively.
Thus, a positive effect - remission for 12 months or more was observed in 106 (57.92%) of women with urinary incontinence and withhold,
of whom 54 (43.55%) patients with chronic recurrent cystitis.
The results of clinical application of techniques for chronic inflammatory diseases of the pelvic pain syndrome
and a disorder of the venous and arterial circulation (chronic pelvic pain syndrome) during rehabilitation, dyspareunia.
Objective:
To evaluate the effectiveness of the use of photographic and electrical stimulation in patients with chronic
pelvic pain syndrome.
Materials and methods. We conducted a survey in monitoring the dynamics before and after treatment
in 74 women aged 29 to 43 years with disease duration from 2 to 10 years.
In 62 (83.78%) patients in the complaints, it was noted the presence of pain, occurs when sexual intimacy that was the cause
of violation of the harmony of sexual relations; 23 (31.08%) patients, in the last time began to shy away from sexual intimacy.
After the course of examination and determination of objective evidence of dyspareunia on the background
of chronic inflammatory diseases of the pelvic pain syndrome and a disorder of the venous and arterial circulation
(chronic pelvic pain syndrome), we administered a course of physical therapy with the inclusion
of a photo session, and electrical stimulation - a technique 1 then 5.
The first examination of patients was carried out at the end of the next menstrual period,
after completion of a course of physiotherapy.
In this case 41 (55.4%) the woman at the survey by interview, noted the absence of pain.
During sexual intercourse 13 (17.57%) women from among those who complained of pain during sexual intercourse,
noted the absence of pain.
Thus, a positive effect - no pain at the end of the course of physical therapy was observed in 43 (58.1%) patients.
The results of clinical application of techniques to strengthen muscles while reducing neuromuscular excitability
and recovery normotonusa muscles of the pelvic floor in the late postpartum period.
Objective:
To evaluate the efficiency of photo-pneumatic and electrical stimulation in patients with a decrease neuromuscular excitability,
and rebuilding normotonusa muscles of the pelvic floor in the late postpartum period.
Materials and methods
. We conducted a survey in monitoring the dynamics before and after treatment of 24 women aged 26 to 34 years.
All patients were asked to receive consultative no earlier than 6 months after the re-birth.
Gynecological examination revealed the presence of lowering the tone of the pelvic floor muscles,
lowering the tone of the vaginal walls, 8 (33.33%) patients noted withhold urine during physical exertion.
Slowing down phase of sexual arousal with adequate gratification celebrated all patients, and that was the reason for seeking advice.
Patients were assigned physical therapy, each treatment session consisted of a consistent implementation of the three methods of photo,
pneumatic and electrical.
At the beginning of the session based on the methodology 1, 6 and then the method terminates the session holding method 3.
First examination of patients was carried out at the end of the next menstrual period,
after completion of a course of physiotherapy
. Positive dynamics observed 15 (62.5%) patients, which was confirmed at the gynecological examination,
in 5 (20.83%) women had disappeared symptoms of non-withholding of urine.
At the same time 9 (37.5%) patients who had not achieved a positive result, the effect was observed after the second course
of physiotherapy sessions.
Thus, the appointment of successive sessions of photos, pneumatic and electrical stimulation in patients with a decrease
neuromuscular excitability,
and to restore normotonusa muscles of the pelvic floor in the late postpartum period has a beneficial effect in 62.5%.
To maximize the effectiveness of the recommended physiotherapy sessions - two sessions of the course it is advisable to carry out.
Discussion.
The base therapeutic effect is based on the use of techniques electrostimulation at all stages of treatment.
This mioneyrostimuliruyuschee, vasoactive and neurotrophic effects it allows you to have a muscle tissue
of all anatomical structures pelvic stimulating effect.
The rhythmic contraction of muscle cells with a predetermined controlled rhythm provides them with training,
normalizes biopotentials thresholds of cell membranes.
It can be assumed that the improvement in the achievement of the above-described mechanism for simultaneous
electrical stimulation caused the normalization of all types of metabolism in tissues of the area of its influence.
This allows for the generation of singlet oxygen by the use of phototherapy.
The use of phototherapy in combination of blue and orange-red laser radiation at a first stage allows a session start to affect
the membrane of muscle cells, peripheral nerves, connective elements to achieve stabilization
and reduction of rigidity of cell membranes, decrease of the antigenic properties of tissues, normalization peroxidation cyclic and aliphatic compounds.
This stimulating effect on the biologically active substance in the tissue allows us to try
and influence the pathogenic mechanisms that caused the formation of symptom,
which require in-depth scientific analysis and clinical observations - at disturbances in achieving orgasm,
chronic pelvic pain syndrome, withhold urine.
The wavy mioelektrostimulyatsiya the second stage of the session with the development of the wave,
"the cervix and upper third of the vagina - the middle third of the vagina and the G point - the lower third of the vagina
and vaginal opening" allows you to simulate poocherednost contraction of muscles to imitate the physiological orgasmic waves.
Pnevmovozdeystvie on lacunar tissue, and especially the front wall of the vagina with the erogenous zone
of the first order in here - the G-point, provides additional stimulation component sensornoaktivnyh tissues.
Mechanical impact during pnevmostimulyatsii reduces the threshold sensitivity of the neuromuscular complex of the
zone responsible in the formation of the vaginal part of adequate sexual arousal and orgasmic plateau.
A similar mechanism occurs at pnevmovozdeystviya lacunar tissue and bladder neck at the non-withholding and incontinence.
conclusions
Using MEMS urogynecological stimulant, providing a photo, pneumatic and electrical stimulation in the treatment
of sexual dysfunctions provides a positive result in 56.67% of women with disabilities in achieving orgasm,
57.92% - to withhold and incontinence of urine, 58.1% - on chronic inflammatory diseases of the pelvic pain syndrome
and a disorder of the venous and arterial circulation (chronic pelvic pain syndrome) and in 62.5% of patients with
a decrease in neuromuscular excitability of the pelvic floor muscles and helps restore
normal muscle tone of the pelvic region in the late postpartum period.
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