Efficacy of transcutaneous perineal electrostimulation versus intracavitary anal electrostimulation in the treatment of urinary incontinence after a radical prostatectomy: randomized controlled trial study protocol

Background Radical prostatectomy is the gold standard treatment for men with localized prostate cancer. This technique is associated with post-operative urinary incontinence. Pelvic floor physiotherapy is a conservative, painless and economical treatment for this specific situation. Kegel exercises and perineal electrostimulation are common techniques to train pelvic floor muscles. The perineal electrostimulation can be applied to the patient with surface electrodes or by an intra-cavitary anal probe. This study proposes that transcutaneous perineal electrostimulation is as effective as intra-cavitary electrostimulation in reducing urinary incontinence secondary to radical prostatectomy. The main objective is to compare the efficacy of the treatment with transcutaneous perineal electrostimulation versus the same intra-cavitary treatment to reduce the magnitude of urinary incontinence after radical prostatectomy, and the impact on the quality of life. Methods This single-blind equivalence randomized controlled trial will include 70 man who suffer urinary incontinence post radical prostatectomy. Participants will be randomized into surface electrodes group and intra-anal probe group. The groups will receive treatment for 10 consecutive weeks. Outcomes include changes in the 24-h Pad Test, and ICIQ-SF, SF-12 and I-QoL questionnaires. Clinical data will be collected at baseline, 6 and 10 weeks after the first session, and 6 months after the end of treatment. Discussion The results will allow us to prescribe the most beneficial perineal electrostimulation technique in the treatment of urinary incontinence derived from radical prostatectomy. Trial registration ClinicalTrials.gov Identifier: NCT03587402. 27/06/2018

PLAY ME: interactive sonification of sexual arousal in long-distance relationships

Music is the best medium for expressing emotions and arousal nonverbally. PLAY ME is a gender-neutral Arduino-based system that allows partners in a long-distance relationship to perceive each other’s sexual arousal and to provide stimulation of erogenous zones using music. PLAY ME’s main parts are a tiny pneumatic anal probe connected to a pressure sensor and a bodysuit with integrated vibrators. Whenever both partners wear these devices, a real-time exchange of emotions and corporeal feelings can be enabled. Three sensors capture genital sexual arousal and transform it into music: a pulse sensor, a sensor for galvanic skin response and a pneumatic anal pressure probe. The anal probe measures pelvic tensions and contractions. Its signal controls the main voice. Higher arousal leads to stronger pelvic muscle tensions. Measured data are mapped to pitch, so the level of sexual arousal is audible in a comprehensive way, and orgasms can be clearly identified by regular pulsating sounds. The pulse sensor and the skin response sensor are the driving rhythm and drone frequency. The vibrators in the bodysuit are controlled by sound that is generated by the partner using any audio source. Mixing the sounds generated by the sensors and the instrument leads to interactive music that can enhance erotic feelings and sexual arousal in the way of biofeedback. This article describes the background and construction of the PLAY ME system and shows diagrams of sensor values recorded during sexual stimulation. After a discussion of the results, there is an outlook toward further development.

Functional assessment of the pelvic floor muscles by electromyography: is there a normalization in data analysis? A systematic review

ABSTRACT This study aims to evaluate the method of analysis of electromyographic data considering the functional assessment of pelvic floor muscles (PFM). We have included in our search strategy the following databases: Medline, PubMed, Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews, PEDro, and IBECS, considering articles published in the last ten years (2004-2014). The identified articles were independently examined by two evaluators, according to these inclusion criteria: (1) population: female adults; (2) PFM assessment by electromyography (EMG) with vaginal/anal probe; and (3) description of how electromyographic data analysis is performed. The Newcastle-Ottawa Scale (NOS) was used to assess the risk of bias. We identified 508 articles, of which 23 were included in the review. The data showed differences between the collection protocols, and a significant number of studies did not normalize the electromyographic data. Physiotherapists are among the clinicians who most frequently use EMG to evaluate the function and dysfunction of the neuromuscular system. Although some previous studies have provided an overview to guide the evaluator in the assessment, few succeeding studies followed their recommendations.