How does continence stimulation work?

Continence Stimulation is a therapeutic, safe and highly effective treatment for incontinence that is recommended by doctors, continence advisors and physiotherapy departments throughout the world.

Around 30% of women and 11% of men experience urinary incontinence at some time in their lives.

There are three main types of incontinence:

Stress Incontinence describes leakage of urine when you cough, sneeze, strain, or make sudden movements. It is particularly common in older women and occurs when the bladder neck or pelvic floor muscles that act to hold urine in the bladder are not working properly.

Urge Incontinence describes an overactive bladder. You may experience a strong sudden urge to go to the toilet so that you are not always able to hold on, or have to go more frequently than normal.

Mixed Incontinence is a combination of both Stress and Urge Incontinence.

ADVANTAGES OF CONTINENCE STIMULATION

• Cure not containment – continence stimulation techniques work to resolve incontinence issues by re-strengthening the muscles needed to contain urine in the bladder; working to cure the issue rather than acting to just manage the issue (such as using containment pads etc).
• Minimal running costs – continence stimulation is a more cost-effective solution to incontinence than containment. Purchasing just one pelvic floor exerciser or trainer can provide a long-term cure – with noticeable results in just weeks - as opposed to purchasing daily containment pads for the rest of your life.
• Drug Free – continence stimulation is a drug-free, non-surgical, long-term solution – leaving the user in control of their own treatment.
• Portable – units are portable, mostly discreet, and can be used at home –saving various trips to medical centres.

BEFORE PURCHASE, PLEASE READ THE FOLLOWING WARNING:

Incontinence can have many causes. TensCare Stimulators should never be used unless the cause and source of the incontinence have been diagnosed by a medical practitioner

HOW CONTINENCE STIMULATION WORKS

An electrical current is delivered through an intra-vaginal probe for women or a rectal probe (Type XPR) for men. In women, the second channel can be used with an optional rectal probe to give increased response. External surface electrodes may be used as an alternative if internal probes are not appropriate.

Electrical stimulation works in different ways depending on the program used.

The STRESS incontinence program is based on strengthening the muscles of the pelvic floor by electrical stimulation.

Once muscular strength has been improved, these muscles are better able to resist urinary leakage caused by external pressure being applied to the bladder - such as with a cough, sneeze or physical exertion.

If muscles are in poor condition, it is often difficult to feel the muscles you need to exercise, and unused nerve pathways may make it difficult to control your muscles. The stimulator sends signals that are similar to those sent by your brain, but stronger and targeted at the right site. A medium-frequency current causes the muscles to contract and work, and builds muscle strength and bulk.

Stimulation via a rectal probe (XPR) may also be used to improve the function of the anal sphincter in the treatment of faecal incontinence in both males and females.

URGE incontinence is primarily the unwanted and unexpected emptying of the bladder due to its muscles contracting involuntarily.

A lower-frequency current has been shown to have a beneficial effect in reducing the involuntary contractions in URGE Incontinence. It works by slowing down the rate of false signals sent to the brain.

With STRESS Incontinence, improvement comes slowly with the building of muscle fibre, nerve sensitivity and blood supply. Successful treatment will require stimulation once a day for one to three months.

With URGE Incontinence, improvements can be seen in as little as two weeks.

WHAT DOES IT FEEL LIKE?

Stress Incontinence

Increase the stimulation intensity until you feel a strong but comfortable sensation of ”tightening or lifting”. The stimulation lasts five seconds and then stops for ten seconds. Continue to increase the intensity until it is as high as you can comfortably stand. The medium frequency is only effective if the muscle contracts. You will start to feel sensation at a level BEFORE the muscle starts to contract.

You may need to increase the intensity during the treatment to keep the sensation constant as the body gets used to the feeling.

The stimulation helps you to feel where your pelvic floor muscle is. As your muscle becomes stronger, try to keep it tensed after the stimulation stops. This helps to re-create the natural link between your brain and the muscle.

Like any exercise, you need to rest the muscle. The faster the stimulation frequency, the more rest is needed.

Urge Incontinence

The Urge program causes a “pulsing or tapping” sensation. Increase the intensity to just before the point where the muscle starts to contract. If you get an aching sensation during a treatment, reduce the intensity, and speak to your advisor about reducing the Work time setting.

The stimulation helps you to feel where your pelvic floor muscle is. As your muscle becomes stronger, try to keep it tensed after the stimulation stops. This helps to re-create the natural link between your brain and the muscle.

The best work of all for your pelvic floor is exercise without the stimulator. Once you have built up strength and sensation with the stimulator, keep up regular pelvic floor exercises – the pelvic floor needs exercise like any other muscle!

INSERTION OF PROBE

If necessary, use the toilet before beginning the treatment. 

Ensure the unit is switched OFF before inserting the probe.

Lubricate the probe with lubricant gel or water and insert it as you would insert a tampon until the flange on the end meets the body. The probe will naturally position itself with the widest part of the loop horizontal.

For treatment, get into a comfortable position, sitting or lying with your knees up. You can sit on a rolled up towel to tilt your thighs into a position where the probe cannot fall out.

When and for how long will I need to use Continence Stimulation?

Stress Incontinence can take a long time to respond as the muscle can only build slowly. Treatment should be continued for up to twelve weeks. Keep a diary to record how often you have a problem, both awake and in bed, and how much you leak. When you do start to make small improvements, this record will help to motivate you.

The duration of each period of stimulation can be varied – for example from 10 minutes to begin with, up to 30 or 40 minutes as your treatment programme progresses. The length of each session for muscle strengthening will also depend on your ability to contract and resistance to fatigue.

As with any muscle re-education, the saying "no gain without pain" does apply –muscles need to be "pushed" into performing at their best. However, your treatment programme should not be painful or an ordeal. Levels of stimulation intensity and period of use should be tailored to suit your particular needs and abilities.

Urge Incontinence can respond very quickly - in as little as two weeks.

If you cannot feel anything when the intensity is increased, you may be suffering from a loss of normal sensation. This numbness should rectify with treatment. However, to ensure that you do not over-stimulate the muscle, and to avoid a nasty surprise if the probe slips out, do the following:

• Turn the intensity down to 1 or 2.
• Withdraw the probe until it is about halfway out.
• Increase the intensity as high as you can comfortably set it.
• Replace the probe.

OPTIONAL ANAL PROBE

Some clinicians favour the use of two probes simultaneously to maximise stimulation to the pelvic floor. A special Anal Probe and leads (L-BPT and X-AP) are available as optional extras. The second channel is used in exactly the same way as the first.

PROBE HYGIENE

The probe supplied is intended for single patient use. It is important that the probe is cleaned after each use.

Clean in warm soapy water, rinse and dry thoroughly. The probe should be replaced every six months.