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Aims The overactive bladder syndrome (OAB) is defined as urinary urgency, usually accompanied by frequency and nocturia, with or without urgency urinary incontinence. Biofeedback-assisted pelvic muscle therapy (BAPFMT) is a first-line treatment option for OAB. The aims of this study were to determine the efficacy and effectiveness of BAPFMT on symptoms of OAB after 9 weeks of treatment and to detect changes EMG activity of individual pelvic floor muscles (PFM) with the MAPLe. Methods Patients were randomly divided into an intervention group that received BAPFMT with the MAPLe or into a control group which received only toilet behavior and lifestyle instructions. The Pelvic Floor Inventories (PeLFIs), the King's Health Questionnaire (KHQ), a voiding dairy, a 24 h pad-test, and vaginal EMG registration of the pelvic floor with the MAPLe were used at inclusion and after 9 weeks follow-up to determine the effect of BAPFMT on complaints of OAB and Quality of Life (QoL). Results Fifty-eight patients were included. The PeLFIs, KHQ, voiding dairy, and 24 h pad-test showed significant improvements in the intervention group compared to the control group in complaints of OAB and QoL. EMG activity showed significant improvements for specific individual muscles at the different sides and depths for rest, maximal voluntary contraction, and endurance. Conclusions EMG BAPFMT is effective in the OAB syndrome in women. It significantly reduces symptoms and complaints of OAB and increases QoL for patients. It shows that EMG changes in individual PFM, measured with the MAPLe, are relevant and related to symptom reduction. [ABSTRACT FROM AUTHOR]

OBJECTIVE To correlate, in a pilot study, the clinical results of extracorporeal magnetic innervation therapy (ExMI) of the pelvic floor muscles with functional changes in the pelvic floor musculature, urodynamics and quality of life. PATIENTS AND METHODS In all, 74 patients (65 women and nine men) with urge incontinence, urgency/frequency, stress incontinence, mixed incontinence and defecation problems were included in a prospective study of ExMI using a ‘electromagnetic chair’. All patients were treated twice weekly for 8 weeks. Digital palpation and biofeedback with a vaginal or anal probe were used for registration of the pelvic floor musculature. A urodynamic evaluation, a voiding diary, a pad-test, the King's Health Questionnaire (KHQ) and a visual analogue scale (VAS) were completed by the patient at baseline and at the end of the study. RESULTS In the group as a whole, there were no significant differences in the voiding diary, pad-test, quality of life, VAS score, biofeedback registration and urodynamics before and after treatment. Additional stratification was applied to the total patient group, related to the pretreatment rest tone of the pelvic floor, the basal amplitude registered on electromyography, to age and to previous treatments. However, there were no significant differences in the data before and after treatment within all subgroups (stress incontinence, urge incontinence, urgency/frequency, defecation problems, overactive pelvic floor, age, previous treatments), except for the KHQ domain of ‘role limitations’, where there was a significant improvement in all groups. CONCLUSION ExMI did not change pelvic floor function in the present patients. The varying outcomes of several studies on ExMI stress the need for critical studies on the effect and the mode of action of electrostimulation and magnetic stimulation. In our opinion ‘the chair’ is suitable to train awareness of the location of the pelvic floor. However, active pelvic floor muscle exercises remain essential. [ABSTRACT FROM AUTHOR]

In prostate cancer, confirmation of metastatic involvement of the skeleton has traditionally been achieved by bone scintigraphy, although the widespread availability of prostate-specific antigen (PSA) measurements has tended to eliminate the need for this investigation. The potential of bone scintigraphy to predict skeletal-related events, particularly spinal cord compression, after the onset of hormone refractoriness has never been investigated. The aim of this study was to establish whether a new method of evaluating bone scintigraphy would offer a better predictive value for this complication of the metastatic process than is achieved with currently available grading methods. We studied 84 patients with hormone-refractory prostate cancer who had undergone bone scintigraphy at the time of hormone escape. Tumour grading and parameters of tumour load (PSA and alkaline phosphatase activity) were available in all patients. The incidence of spinal cord compression was documented and all patients were followed up until death. Bone scintigraphy was evaluated by the conventional Soloway grading and by an additional analysis determining total or partial involvement of individual vertebrae. In contrast to the Soloway method, the new method was able to predict spinal cord compression at various spinal levels. Our data suggest that there is still a place for bone scintigraphy in the management of hormone-refractory prostate cancer. [ABSTRACT FROM AUTHOR]

Differential kidney function is usually studied by quantification of relative renal uptake at 2-4 h after injection of the radiopharmaceuticalTc-dimercaptosuccinic acid (DMSA). The outcome of this measurement, however, may be unreliable in cases of obstructive uropathy. The obstructed kidney may retain the radiopharmaceutical in the dilated system, which may lead to relatively high values for functioning cortical mass. In this situation, determination of the split kidney function at 24 h instead of 4 h after application ofTc-DMSA has been advocated. In order to compare results at 4 h and 24 h an investigation was performed in 8 patients with obstructive renal disease present for more than 2 weeks, and in 7 patients who did not suffer from obstruction. In these 15 patients the differential function measured at 4 h and at 24 h was the same. From our results we conclude that overestimation of the function of an obstructed kidney byTc-DMSA scanning at 4 h is not a major problem. According to the literature, however, in cases of acute obstruction or 'complicated' obstruction with stones or infection,Tc-DMSA scintigraphy can underestimate the potential function of the obstructed kidney. [ABSTRACT FROM AUTHOR]

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In prostate cancer, confirmation of metastatic involvement of the skeleton has traditionally been achieved by bone scintigraphy, although the widespread availability of prostate-specific antigen (PSA) measurements has tended to eliminate the need for this investigation. The potential of bone scintigraphy to predict skeletal-related events, particularly spinal cord compression, after the onset of hormone refractoriness has never been investigated. The aim of this study was to establish whether a new method of evaluating bone scintigraphy would offer a better predictive value for this complication of the metastatic process than is achieved with currently available grading methods. We studied 84 patients with hormone-refractory prostate cancer who had undergone bone scintigraphy at the time of hormone escape. Tumour grading and parameters of tumour load (PSA and alkaline phosphatase activity) were available in all patients. The incidence of spinal cord compression was documented and all patients were followed up until death. Bone scintigraphy was evaluated by the conventional Soloway grading and by an additional analysis determining total or partial involvement of individual vertebrae. In contrast to the Soloway method, the new method was able to predict spinal cord compression at various spinal levels. Our data suggest that there is still a place for bone scintigraphy in the management of hormone-refractory prostate cancer.