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.



Incontinence Intravesical therapy


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Author RS R & D
Copyright 1995[RS R & D].