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Selected Works of Ruth Maher
Presentation
Through the looking glass – The effects of INNOVO shorts on the pelvic floor as assessed with dynamic ultrasound imaging
The Association of Coloprotcology of Great Britain and Ireland Annual Meeting (2019)
  • Ruth M Maher, Philadelphia College of Osteopathic Medicine
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Abstract
Purpose:
To demonstrate that INNOVO elicits pelvic floor muscle contractions (PFM).
 
Methods
Thirty females (10 stress urinary incontinence (SUI)) provided informed consent. Each donned the INNOVO device in standing with intensity modified to elicit PFM contractions visible on ultrasound imaging (US). Transabdominal (TAUS) and transperineal (TPUS) US cineloops were acquired using a curvilinear transducer. Appropriate contractions were defined as cranial (TAUS) and cranioventral (TPUS) )displacement of the bladder base and neck respectively.
 
Results
Contractions were observed for all participants. Mean displacement of bladder base via TAUS was 0.96 cm (SD 0.53cm). TPUS revealed INNOVO elicited contractions changed the ano-rectal angle with concomitant anterior urethral displacement towards the pubic symphysis.
 
Conclusion
Pelvic floor training is an effective first line therapy for many pelvic floor disorders.  Ability to perform contractions is essential to successful outcomes but are challenging for many to perform appropriately.  These individuals may use vaginal/anal probes with electrical stimulation (ES) to facilitate contractions.  However,  the  evidence regarding this method of ES reports contractions occurring in only 11 – 16% in addition to limited compliance due to large current densities, pain and or bleeding. The INNOVO device has extremely low current density and elicits comfortable contractions. Efficacy is high in SUI  with 93% improved in 4 weeks and 87.2% dry or categorized as mild SUI. Given the quality of the elicited contractions noted on US and reported outcomes,  INNOVO offers a safe and effective non-invasive option for those with pelvic floor disorders such as fecal incontinence and pelvic organ prolapse.
 
 References
  1. Constantinou CE. Dynamics of female pelvic floor function using urodynamics, ultrasound and Magnetic Resonance Imaging (MRI). Eur J Obstet Gynecol Reprod Biol. 2009;144 Suppl 1(Suppl 1):S159-65.
  2. Bump, RC. Hurt, WG. Fantl, JA. Wyman, JF. Assessment of Kegel pelvic muscle exercise performance after brief verbal instruction. Am J Obstet Gynecol. 1991; 165 (2): 322-327.
  3. Castro RA, Arruda RM, Zanetti MR, Santos PD, Sartori MG, Girão MJ. Single-blind, randomized, controlled trial of pelvic floor muscle training, electrical stimulation, vaginal cones, and no active treatment in the management of stress urinary incontinence. Clinics (Sao Paulo). 2008;63(4):465-72.
  4. Bø K, Maanum M. Does vaginal electrical stimulation cause pelvic floor muscle contraction? A pilot study. Scand J Urol Nephrol Suppl. 1996;179:39-45.
  5. Maher R, Caulfield B.  A Novel Externally Applied Neuromuscular Stimulator for the Treatment of Stress Urinary Incontinence in Women-A Pilot Study. Neuromodulation: Technology at the Neural Interface, 2012; 16(6): 590-594.
  6. Maher RM, Hayes DM. Does Transvaginal Neuromuscular Electrical Stimulation Elicit a Pelvic Floor Muscle Contraction? - A Pilot Study Using Sonography in Healthy females. Journal of Women’s Health Physical Therapy, 2012;36 (2): 102-107.
  7. S. Kim, V. Wong, K.H. Moore. Why are some women with pelvic floor dysfunction unable to contract their pelvic floor muscles?Aust N Z J Obstet Gynaecol. 2013; 53, 574-579.
  8. Dmochowski R. Novel External Electrical Muscle Stimulation Device for the Treatment of Female Stress Urinary Incontinence: Randomized Controlled Trial Versus Intravaginal Electrical Muscle Stimulation.  Podium Presentation (Abstract 234) ICS Annual meeting, Philadelphia, 2018
Keywords
  • Ultrasound imaging,
  • Pelvic floor function,
  • Stress urinary incontinence,
  • INNOVO
Disciplines
Publication Date
Summer July 2, 2019
Location
Dublin, Ireland
Citation Information
Ruth M Maher. "Through the looking glass – The effects of INNOVO shorts on the pelvic floor as assessed with dynamic ultrasound imaging" The Association of Coloprotcology of Great Britain and Ireland Annual Meeting (2019)
Available at: http://works.bepress.com/ruth-maher/14/