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Medical Forum / Diseases and Disorders / Prostate Cancer / August 2004About TENS Therapy for Incontinence After RP
(This is actually a re-post. Since there were no resonses at all from this helpful group, I assumed that I made some sort of error in posting it. It is a serious question. I am having the surgery sometime in the next month and would like to explore these ideas before, if possible. If I didn't follow some accepted protocol for the group, you have my appologies. I didn't actually SEE a FAQ.) I have run across several mentions of using "TENS" or "Electrostim" devices as therapy for incontinence following RP. I have an electostimulator which I have used for a knee replacement and several other muscle injuries. I was amazed that the thing worked as well as it did after we got it. It's a damn good thing it did, because it was VERY expensive. So, I know that it CAN improve muscle strength and function if used properly. But all I've been able to find about using it for post-RP are just mentions that you CAN. What I have NOT seen is any discussion of the necessary "probes" or electrodes. (A Google search leads you to a lot of sex toy dealers but not much else. Ironically, the sex toy dealers MAY be selling the right things, but somehow I doubt it.) Who makes them? Where can you buy them? How do you specify what you need? What are re-commended therapy procedures? Has anyone seen anything more detailed on this theraputic approach? (FWIW, my Urologist didn't seem to be "up" on this idea when I asked. So he really wasn't much help with the idea. He didn't say it was a bad one, just that he didn't know much about it.) Thanks for any info or advice. jp "I may be old, but I know what I like!" I think no one answered your post because no one knew anything about it. I don't think I've ever heard anyone mention using a TENS for incontinence. I have no clue how it would be used, etc. Here's a couple of ideas. Contact the doctor who first prescribed the TENS. He might know how to use it for incontinence or might know who would. Also contact the manufacturer of your unit. Don't go into surgery looking for problems. Do lots of walking now. Do lots of Kegels or pelvic floor exercises. Depending on what happens during the surgery you might be dry from the time the cath comes out. Most guys only have a problem for a short time. Yes, there are those who have problems over a long period of time. I think if you have a serious problem with incontinence then you might want to delve further into the possibility of using your TENS. If it works I think there are a few guys out here who would be willing to try it. I'm sorry if this is not much of an answer. Bev > (This is actually a re-post. Since there were no resonses at all from this > helpful group, I assumed that I made some sort of error in posting it. It is a [quoted text clipped - 39 lines] > > "I may be old, but I know what I like!" Thanks for the response...at least I know I've got the "communication loop" working right now. I'll keep reading the existing messages...there are a lot...and learn what I can. I have plenty of time it seems...since my diagnosis, I've slept about 1 hour a night. The rest of my time is spent worrying about what I now must go through. I'm still recovering from a knee replacement (that I actually looked forward to doing, pain and all). Exercise is possible, but amusing. WALKING--which seems to be highly recommended--is the hardest thing I can do! I realize (from reading this group) that I'm not unique or "alone" but it's still "me" that must deal with all of this, and my particular "me" is scared to death. Thanks again. jp >I think no one answered your post because no one knew anything about it. I >don't think I've ever heard anyone mention using a TENS for incontinence. I [quoted text clipped - 73 lines] >> >> "I may be old, but I know what I like!" jp "I may be old, but I know what I like!" hi jp - being very familiar with what the TENS unit does in terms of pain, i think i can explain some things to consider. my wife is in constant back pain and has been for over 30 years. back in the early 80's she use to go to a pain management doctor who specialized in chronic pain and headaches. the TENS units were used a lot as well as a special technique of shots. he would follow the nerve's trigger points and the shot would "relax" them. when the nerves in the back would misfire, it generates a stimulus pulse which goes out to the muscle group and causes that muscle group to contract - much like a charlie horse. only the charlie horse will release and relax. this type of stimulus will not. the muscle would stay locked up for days and days. the shot would cause the nerve stimulation to subside and the TENS unit is used to reverse the current carrying pain messages to the brain. you see, the body is polarized in carrying messages, in the fact that pain messages travel from one point to the other. and if you reverse the signal, it is like de-magnetizing a magnetic. the pain is still there, like a piece of steel, but the steel is not magnetized and can not pick up anything. the nerves are interrupted and the pain message is blocked. you can use and control your normal muscle function, but you don't feel the pain or very little of it. unfortunately, the nerves will re-polarize and start carrying the pain messages again and you will need another TENS treatment to shake up the message center again. i remember watching the technician placing the patches on her back and watching the different muscle groups vibrate or quiver. so, i know why you are asking the question of using the TENS unit for training for bladder control. in theory, it sounds like it would work because it would be like doing a lot of series of kegels. the bladder muscle would contract very fast and be given a workout. but here's the down side of all of this. the patches are on the outside from what i've seen and travel along the skin surface using it as a conductor. the new bladder valve is deep inside the body, so how would one attach the patches to stimulate just the bladder valve only? next, the TENS unit is dangerous. that was the very first thing we were taught. using it for pain management, it is easy to crank it up too high and destroy the nerves because they are fragile. the idea was not to destroy them, but to disorient them. what this means to me, is that it would be too easy to crank up the power of the TENS unit to damage the new bladder muscle (since it has just been freshly sewn in and held by stitches) and since this is the only one you have and if something went amiss, you would pay for it the rest of your life. at least that is my take on the TENS units. they work fine and do a great job - in the applications they are designed for. unless, there is something that i'm missing, i would take a pass on this one. just my .02 cents. ~ curtis knowledge is power - growing old is mandatory - growing wise is optional "Many more men die with prostate cancer than of it. Growing old is invariably fatal. Prostate cancer is only sometimes so." > (This is actually a re-post. Since there were no resonses at all from this > helpful group, I assumed that I made some sort of error in posting it. It is a > serious question. I am having the surgery sometime in the next month and would > like to explore these ideas before, if possible. I did see your earlier post but, as with Bev, I never responded because it's a subject I don't know anything about. In addition to Google searching, I tried PubMed and found there were some articles about it - but they aren't how to do it articles. I also wasn't sure that it was being used by men since the few references I saw were for female incontinence - which I presume is very different from the incontinence men may suffer from after prostate surgery. I like Bev's suggestion of contacting the manufacturer. If anyone knows, I would think they would. If you get no info from them, maybe try contacting some of the other TENS device manufacturers. If you do find out something, please let everyone know about it. Alan Thanks to Alan and Curtis for their input. I am aware that the TENS devices can be dangerous if not used properly. Since I've experienced the effects, I can see where overenthusiastic use could cause some serious BAD effects. I certainly am not going to "experiment" on ME. Which is why I started searching for info. I have seen the references to female incontinence (which is sort of where I started thinking). I am pretty sure that those applications use a vaginal or rectal insert of some design. Males certainly share some of the same anatomy but there may be enough differences that none of the female approaches will work. I'm still searching for a Doctor who is familiar with (or uses) such techniques to get some input. I think I may have mentioned that I have a good TENS unit, so, with the proper information and supervision, I could try it.....BUT I'm a long way from trying to "do it myself". I'll pass on what I learn. Thanks, John (still in a state of semi-panic over the whole thing!) >> (This is actually a re-post. Since there were no resonses at all from this >> helpful group, I assumed that I made some sort of error in posting it. It is a [quoted text clipped - 20 lines] > > Alan jp "I may be old, but I know what I like!" hi john - what you said makes perfect sense. on the TENS unit, you must have two points for the electrical pulse to travel to and from. of course, in pain management, it is going across the pain carrying message centers. but the female is built different than the male. on the female. one can picture placing the electrode points on each side of the area where the bladder muscle would be. but the way a male is built, he is short one of those two points. and attaching the electrode patch to outside of on the skin as compared to internal probes, would cause the path of electrical stimulus to go between the point of insertion to the skin patch electrode, which, in my opinion, it would not be near the bladder muscle. one would probably get more toning done with the rectal muscle and that wouldn't necessarily a bad thing is someone is having weak muscles in that area. so, i think that it has merit. i just don't know if it would work on incontinence, but am interested. here's a thought. as i was typing this out, it was just a brain twinge, but wouldn't that be something if one could apply the patches to improve the muscles affected of the ED problem, that then again - OUCH - those electrical jolts hurt. ~ curtis knowledge is power - growing old is mandatory - growing wise is optional "Many more men die with prostate cancer than of it. Growing old is invariably fatal. Prostate cancer is only sometimes so." Curtis, You bet TENS unit pulses CAN hurt, but after we started this discussion, I got the unit out and did a test on my abdomen using two of the 2" square "electrode" pads just about 5 inches apart near my navel. I just started at "0" and slowly upped the level (voltage?) until I could feel something. When I used the machine on my knee muscles it was always set to about "5" on the intensity scale...I could feel the effects, but I certainly would not call the effect pain. You can adjust the TENS for pulses that go from totally undetectable to just perceptible tingles, to stronger "buzzes", to "near-pain" in a continuous mode. I would guess that somewhere on that scale would be a "tollerable" setting (but would it be a useful setting? Aye, THERE'S the rub! As I said before, I'm not really afraid of the device or it's direct effects...they are very controllable. I am inclined to be very cautious about using it for this idea, however. I had a Rehab Therapist working with me on the knee and she knew where to place the pads, how long to apply the pulses, etc. (she did always say to set the level to a point where I could feel it, but to stop BEFORE I sensed it as pain. So that's probably a good initial quideline.) The caveat there would probaly be that INTERNALLY you might not sense pain soon enough...who knows how profuse the actuall pain sensors are throughout the area. I know you've got good sensors in the bladder, sphincter, etc. because they are how you sense and control your bladder and bowel to start with. BUT THESE ARE THE VERY THINGS THAT ARE GOING TO BE DAMAGED BY THE SURGERY! It's kind of like people with nerve damage to a foot or hand who can burn themselves and not know it...they are still hurt, but don't feel pain. So caution must the the controlling principle in any process. Well, I'll keep exploring this. I'll put up any real progress or information. John (Oh, FWIW, I'm 63, diagnosed T1c, Gleeson 3+3, PSA 5.1 and NOT HAPPY!) >hi john - what you said makes perfect sense. > [quoted text clipped - 25 lines] >"Many more men die with prostate cancer than of it. Growing old is >invariably fatal. Prostate cancer is only sometimes so." jp "I may be old, but I know what I like!" hi john - what you described about the TENS unit should be posted at various groups for all to see. these units are not the cure-all answer, but they sure can provide a lot of relief. and you are indeed right about where to place to pads. i remember the technician constantly referring back to the chart to make sure he did them right. he was very confident of his work, but he always doubled checked everything, so as not to hurt someone. my wife has had diabetes for over 20 years and her nerves are damaged as well as damage from three back surgeries, so you can only imagine the pain she lives in on a daily basis. on a scale of 0-10, her day in about a 6 and when it rains, or turns cold, it goes to 7 or 8 and then, when she tries to do anything using her back, will take to a 10 and above. the TENS unit would bring the pain down to around a 3 or 4, which was a lot better and if the doctor injected the back, she has walked out of the office with zero pain and maybe it would last 48 hours before the pain would start rising again. now, after saying all this and tying it all together - if she was to treat herself for pain, she was told that she would probably burn her skin and not know it until she went to take off the electro pads, and for that reason, would not write the script for her. they said she was a case were there was so much nerve damage that it needed to be supervised. so, as you said, if you were to apply the TENS unit to the area after surgery, i can tell you for a fact of what the surgeon told me. i can complaining about not having certain feelings and he said that they cut a lot of nerves as well as micro nerves, and because they are micro nerves, he does not know where they go to. they are in the way and you can't see them with the naked eye. so, if you applied the TENS unit to the affected area after surgery, even though you were being very cautious with it, there is a good chance you may do a lot more damage than good. and i guess my question is this. if you were to do any damage, could it be straighten up or would the surgeon say, "well, that's all there was and you will have to live the rest of your life under these conditions you caused." i still am very interested in if you find something, i have not found anything relating to this on the web as of to date. but i do have to admit, given the right conditions and being able to control it. the TENS unit could have some very good possibilities. ~ curtis knowledge is power - growing old is mandatory - growing wise is optional "Many more men die with prostate cancer than of it. Growing old is invariably fatal. Prostate cancer is only sometimes so." Here are some interesting items I did find: (I'm still getting up to speed with Google) http://www.va.gov/vatap/pubs/tens.pdf It isn't really information as much as (apparently) a link to information. This is more "on target" but is really about a "sub cutanious" electrode implant: http://www.ichelp.com/TreatmentAndSelfHelp/ManagingICSymptomsWithNeuromodulation Devices.html This is a LOT of general references on TENS therapy itself: http://www.intelihealth.com/IH/ihtIH/WSIHW000/8513/34968/363973.html?d=dmtContent This is a device specifically for the purpose, BUT, it is for women. Just included it because it SEEMS to validate the concept...just not for us! http://www.empi.com/products/incontinence/minnova.pdf This item seems to be right on target - just no real detail: http://www.ic-network.com/handbook/nerve.html This is a long paper on TENS in general, with a specific mention of its use for stress incontinence in women (paragraph 12). http://sulcus.berkeley.edu/mcb/165_001/papers/manuscripts/_673.html This is a report of a study of the "implant" approach using electro-stimulation: http://www.medtronic.com/newsroom/news_20010605a.html This is a very good discourse on TENS and EMS..not specific to incontinence but educational: (It took a long time to load, but it is a good source) http://www.biostimtherapy.com/newsletters/october00/ems10_00.pdf This seems to be slightly away from the idea. It is a study of nerve-impared patients that DID get some improvement from EMS: http://www.mult-sclerosis.org/news/Feb2002/MedlineElectricalStimulationUrinaryDy sfunction.html Still looking. John >Curtis, > [quoted text clipped - 64 lines] > >"I may be old, but I know what I like!" jp "I may be old, but I know what I like!" How about contacting the manufacturer of the TENS. Don't know which one you have, but Medtronic makes them, has a web site, and may be able to offer some assistance. Good luck Zork ======== >> (This is actually a re-post. Since there were no resonses at all from this >> helpful group, I assumed that I made some sort of error in posting it. It is a [quoted text clipped - 20 lines] > > Alan A very good idea. I'll look around the web-sites for "contact us" type links. John >How about contacting the manufacturer of the TENS. Don't know which one >you have, but Medtronic makes them, has a web site, and may be able to [quoted text clipped - 29 lines] >> >> Alan jp "I may be old, but I know what I like!" John: A physical therapist came and spoke to our UsToo meeting about therapy to prevent or ameliorate the effects of incontinence. Perhaps someone at her place could give you some guidance. Her name is Kathy Trisko, P. T., and here's the website of her business: http://www.parkcitiesphysicaltherapy.com/ Larry > (This is actually a re-post. Since there were no resonses at all from this > helpful group, I assumed that I made some sort of error in posting it. It [quoted text clipped - 41 lines] > > "I may be old, but I know what I like!" Larry, I will contact the source you gave me. I'll pass on anything I learn. John >John: > [quoted text clipped - 54 lines] >> >> "I may be old, but I know what I like!" jp "I may be old, but I know what I like!" |
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