Word from the expert: Dr. Antonio Posada – Urinary Incontinence: Suggestions for diagnosis and experience with Dr. Arnold

DEKA Intimate Dr Posada ENG

Feminine urinary incontinence is a symptom which shows with high frequency, which nevertheless is not reported by patients during the first check-ups, nor do general practitioners ask questions in relation to it. It is instead a condition which affects many people the world over and it shoes especially among women after 35-40 years of age, regardless of the number of children they have had. It is obvious that it is more frequent among women who have given birth to a higher number of children, both through vaginal and caesarean delivery, due to the weakening of the pelvic floor ligaments and muscles, along with the lack of hormonal system, which further debilitates ligaments and musculature.

This, combined with these two situations, allows for severe pelvic floor weakening, causing severe or minor urinary incontinence symptoms in patients.

Urinary incontinence is a symptom which is mainly divided into two categories: The first is Stress Urinary Incontinence, which occurs when the patient is under physical strain for reasons like coughing, jumping or running, and presents an involuntary loss or urine. The second category is Urge Incontinence, when the patient presents with the compelling necessity to empty her bladder or experiences urine loss without any effort. Furthermore, there exist a third category, the least frequent, a combination of urge and stress incontinence.

The symptom of urinary incontinence is rarely reported by patients. Nevertheless, when directly asked by the physician, most patients acknowledge having experienced minor or major urine loss. The physician needs to probe the presence of this symptom during the first visit, also if the patient does not spontaneously report it.  

The problem is that when the patient speaks to the practitioner referring to urinary incontinence from stress or other reasons, the patient already presents with a severe degree of urinary incontinence and often needs surgical treatment rather than conservation treatment. Once the patient has reported the symptom of urinary incontinence it is important for the physician to dedicate the necessary time to her in order to ask a series of very specific questions on the characteristics of their urinary incontinence: Does it occur with light or severe strain? Which is the frequency? Is the incontinence diurnal or nocturnal? Does the patient experience urine loss during the night?

All these answers are important to formulate a diagnosis, along with a physical examination performed by the doctor to better define the adequate therapy.

Dr. Arnold’s technology executes a therapy based on high-intensity focused electromagnetism, which allows for the stimulation, specific and localized, of pelvic floor muscles and the inducement, at the same time, of the electromagnetic depolarization of the pelvic floor. We can therefore obtain a reinforcement of pelvic muscles which helps to reduce or, in some cases, to eliminate the urinary incontinence symptom in patients when the condition is minor or, in some instances, moderate.

To obtain adequate results it is important to set treatment parameters which are adequate for the patient’s conditions, which depend a lot on body mass index. For the purpose of treatment efficacy it is also important to assume a correct position in the chair, ergonomically designed to guarantee comfort besides efficacy.

The results of electromagnetic treatment of the pelvic floor have been very encouraging for the patients, who report good progress after the third or fourth session, progress which may last several months after the treatment. We have had patients who, after more than six months, continue to report good results of the electromagnetic treatment on the pelvic floor.

One very important point to make to the patient is that there exist a major difference between training at home and a treatment with Dr. Arnold: The number of contractions, their intensity and duration or contraction strength are quite different from the voluntary exercise which can be done at home compared with the contractions which can be induced by a system like the Dr. Arnold chair. And this is very important for the result, because the patient will never reach an intensity which is adequate or similar to that created by Dr. Arnold.

The advantage of the treatment with the Dr. Arnold chair is very important because the patient does not need any preparation before, during and after the treatment. No special attention is required. It is a totally outpatient procedure which is painless and does not require any anaesthesia. Furthermore, the patient does not need to be undressed, nor does she necessitate any special preparation. The treatment lasts thirty minutes and it is a totally outpatient procedure. Another advantage is that, by undergoing two sessions per week for four weeks, the patient completes a standard base Dr. Arnold treatment.

The treatment with the Dr. Arnold chair may also be used with patients who undergo surgery with a more advanced pelvic prolapse condition: It helps to strengthen the muscle before and after surgery, because those are areas which are not directly involved when we operate a patient.

Already during the treatment patients report noteworthy improvement in their quality of life during the treatment sessions, not only at the end of the treatment but also during the treatment, after the second or third treatment. Their social life and the quality of their intimate life also improve dramatically. The treatment restores confidence in patients, as it allows them to perform regular physical activity and also to have a regular sexual activity, without the fear of urinary incontinence.

Word from the expert: Dr. Maurizio Filippini – Urinary incontinence

DEKA Intimate Word from the expert - Dr. Maurizio Filippini
Let’s dispel a cliché: urinary incontinence is not a natural occurrence that we have to resign ourselves to

We’re at the gym, jogging or a bike workout, loading groceries into the car, picking up a child, a cough, a little more laughter and there’s that drop of urine we can’t hold back.
We are active, dynamic women who do not want to give up our daily activities, social and sexual life.
So we pretend nothing happened, we wear a panty liner, then a menstrual pad, our frustration increases, we resign ourselves.
Today, urinary incontinence is a significant health problem worldwide, with a social and economic impact on women and society and severely affecting quality of life: daily activities, emotional state, social relationships, sexual activity.
In Italy there are about five million people suffering from incontinence, more than half of whom are women, with an average of 1 in 3 over the age of 40.
In fact, it seems that urinary incontinence peaks between the ages of 45 and 59; it is therefore not just a disease of old age. And, fortunately, there are remedies to counteract it.

 

 

Incontinenza urinaria rimedi

 

We talk about it with Dr. Maurizio Filippini, gynaecologist, Head of the Functional Module of Gynaecological Endoscopy at the ISS of the Republic of San Marino

Why is it that, despite being a problem that affects a large number of women, little is said about urinary incontinence?

Until recently, women had no perception of the problem. Most regarded urinary incontinence as a para-physiological situation, it was experienced almost as a condition of old age or as a post-natal symptom.
It can often happen after childbirth, but mostly resolves itself after a while. The vast majority of women, on the other hand, begin to leak urine between 40 and 50, still young, with an intense social life and sexually active.
And it is clear how embarrassing and debilitating it is for them and how much it can also affect them psychologically.
From my experience, I have noticed that they struggle to expose the problem spontaneously, almost as if there were some kind of taboo.
However, when asked directly, they always answer truthfully and report the problem and show a desire to solve this disabling symptom that leads to a very difficult relationship life.

What are the traditional treatment options for improving urinary incontinence?

To date, traditional techniques for improving urinary incontinence mainly involved physiotherapy-type devices. Kegel exercises, the kinesiotherapy invented by Dr. Kegel, allow the physiatrist or physiotherapist to perform contraction and relaxation movements in order to train the pelvic floor muscles to strengthen all the muscles under the urethral plate and thus encourage less urine leakage.
In addition to these traditional physical exercises, there are also other methods, such as the use of vaginal cones. A cone is inserted into the vagina and, naturally, the muscles of the vagina are trained to hold the weight and this training strengthens the muscles of the perineum.
Another type of traditional technique is the so-called external electrostimulation. Electrodes are applied at the level of the perineum that help an electrical contraction, hence a motor neuron response, and here again it is a question of training the muscles to be able to retain urine.
Today we have available the new magnetic field device Dr. Arnold from DEKA DEKA

What is Dr. Arnold and what is its principle of action?

Dr. Arnold is a non-invasive medical device that uses magnetic energy to create fields that impact the entire perineal tissue.
It creates an electromagnetic field that allows the muscle to contract, but with a much more effective contraction than is done manually by a physiotherapist or electrostimulation, because it can reach a high intensity that is usually difficult to achieve with voluntary contraction.
And this is how it is able to intervene on mild prolapses and urinary incontinence.
The treatment is non-invasive, has no side effects, the patient will only feel muscle fatigue, as after high physical activity, and is absolutely comfortable. It involves the patient remaining dressed and sitting in the chair.

…continues with the next appointment.

 

How to solve incontinence

Incontinenza DEKA Intimate

Urinary incontinence is among the most common female problems in women aged 35 and over and seriously impairs quality of life. The causes of incontinence in women can be many: for example, physical changes resulting from pregnancy, childbirth and menopause or the removal of the uterus (hysterectomy) can cause the dysfunction. Today, however, the problem can be solved at the root and in a non-invasive way. Let’s discover the treatment together.

 

How does the treatment work?

The treatment is done while seated, in a special chair, in a position that allows the waves of the special electromagnetic field (TOP FMS) to be directed onto the pelvic floor. Electromagnetic waves act directly on the pelvic floor muscle with contractions and relaxation that strengthen the muscles.

Is the treatment painful?

The treatment is practically painless. Depending on the protocol applied, contractions of different intensities can be felt.

 

Pavimento pelvico DEKA Intimate
What should I do before treatment?

Before undergoing treatment, it is necessary to have a consultation with your doctor in order to identify the protocol best suited to your needs. During treatment, all metal and electronic accessories must be removed. The doctor must be informed about the presence of particular metal prostheses in the area.

How many treatments are needed?

The cycle involves 6 to 8 sessions twice a week. At the end of the treatment course, maintenance treatments are recommended.

How long does a treatment last?

A session lasts an average of 30 minutes.

What should I do after the treatment?

Immediately after treatment, a return to normal daily life is possible.

What results can I expect?

The tangible benefit is a reduction in the severity of incontinence symptoms and a progressive improvement in quality of life.

If you still have doubts or would like an expert’s opinion, read the latest article by Dr. Maurizio Filippini, Gynaecologist and Head of the Functional Module of Gynaecological Endoscopy at the ISS of the Republic of San Marino.