Intravesical electrotherapy
Equipment
INDICATION:
Detruscrareflexia/ Detrusorinstability idiopathic or induced
by:
Myelomeningocele, incomplete spinal cord injury, nerve
lesion, oncologic pelvic surgery, M.Parkinson, Multiple
Sclerosis, Diabetes mellitus, Enuresis nocturna.
CONTRA-INDICATIONS:
complete denervation of the bladder
METHOD:
The THERAPY is based on pulsed, monophasic, square wave,
DIRECT- CURRENT. UROCOM-KL1+ electrotherapy, design and
implementation, are primarily based of the referenced
research of.
KATONA F.: Urol.int 30:192 (1975)
Madersbacher H.: Akt.Urol. 15:248 (1984)
Kaplan W.E.et al.: Urol. 142:600 (1989)
Ebner A.: Proc.Int.Cont.Soc. (1991)
Knoll M., Madersbacher H.: Int.Med.Soc. 31 (1993) 22-27
Madersbacher H.: EBU 2-13 (1993)
A special Catheter containing an electrode, is entered into
the urinary bladder, through transurethral or suprapubic
procedure.
The electrode/catheter system is designed, so that the
electrode can not directly contact bladder mucosa.The neutral
electrode should be mounted externally on the forearm. The
patients retained urine functions as the conductor, or
alternatively, saline solution ca. 100 ml (children 50 ml) my
be used, in order to achieve the necessary bladder fill
volume. If there is no possibility to fill the bladder with
saline solution, the therapy should start not before 60
minutes after the last micturition (dertusorinstability) or
after the last self catheterism (areflexia), this parameter
also can be preprogrammed.
Daily therapy sessions normally range between 20 to 90
minutes.
PROCEDURE:
After a urodynamic examination the indication for
electrotherapy, can be made.
Approximately two to three trial stimulation's under clinical
supervision are necessary, to adjust the seven program
variables; amplitude (intensity), pulse width, frequency,
rise time, package duration, pause time and session duration,
accordingly to the patients need. You can preprogram the 25
programs in the equipment's memory, accordingly to the
guidelines (KATONA F.: Urol.int 30:192 (1975)), or
accordingly to your own experience. During the test sessions
you can select one of this programs, if you are not satisfied
with the bladders reaction, press the "HALT KEY",
and select another program or use the Frequency "+ /
-" and or Current "+/-" to adjust the
Parameter. There is also the possibility to select up to 10
programs, the equipment will execute the selected programs,
and display the results at the end of the last program.
To adjust the intensity during a therapy, you can use the
"REDUCE KEY.S" for 10%, 20%, or 30% reduction.
HOME USE:
For the home use of UROCOM-KL1+, the patient has to be
provided with the instructions (training), necessary to
handle the equipment. The programming of UROCOM-KL1+, should
be done only, by the Doctor or trained clinic Staff. Patients
cannot tamper with pre-programmed settings, without the
clinic CODE of the device, except for allowable reduction in
current intensity "REDUCE KEY.S" if the intensity
exceed the pain threshold. Difference's of the bladder's
reaction due to the therapy, requires usually a readjustment
off the programs parameter weekly.
