INCONTINENCE PROGRAM

Incon Therapy is a revolutionary new treatment which combines the most effective behavioral treatment modalities for the treatment of urinary incontinence and related bladder, bowel and muscle disorders.

This treatment program is patented, non-invasive, non-drug, non-surgery treatment for the re-education & strengthening of weakened pelvic floor muscles to facilitate continence & urethra closure. The treatment includes modalities of computer assisted biofeedback exercises, EMG (electromyography) measurements of muscle activity and behavior modification.

The treatment program is considered medically necessary for patients who need reeducation of specific muscle groups or for treatment of dysfunctional abnormalities such as atrophy, relaxation/weakness and spasm/detrusor instability, when other conventional treatments (heat, cold, Kegel exercises), have not been successful or are inappropriate.

Prospective patients are screened for admittance to the treatment program. A medical history and an incontinence history are taken, and a physical examination is preformed, including a neurological exam, an abdominal exam and a pelvic/rectal exam. Standard laboratory tests include a urinalysis culture and sensitivity, and a Post Void Residual Urine Volume (using a bladder scan). Patient records are reviewed and patients only receive additional tests that are medically necessary to make an accurate assessment.

The therapy is formatted to re-educate and strengthen the bladder and pelvic floor muscles via biofeedback training, the results of which are "stored" in the patient's muscle monitor (hand-held home monitoring device), for interpretation by the clinician at the bi-weekly clinic visits.

Computer assisted biofeedback provides visual and auditory evidence as to the status of these muscles so that a patient can exert voluntary control over the function, thereby alleviating the abnormal/dysfunctional bodily function. In addition to the feedback provided to the patient, the clinician also benefits from the feedback as the data from a personal muscle monitor can be analyzed and interpreted. Furthermore, the digitized EMG recordings provide and objective measurement of the patient's increasing muscle strength.

As the pelvic muscles begin to regain their functional capacity, they begin to support the bladder, effecting more appropriate anatomical position, thus facilitating correct functions. As urethral closure and sphincteric function are recovered, the patient achieves control and coordination needed to maintain continence.

The standard cycle of therapy is twelve visits over a six-week period, unless the patient attains continence prior to the completion of the cycle. For some, for example those with post surgical complications or extremely weak musculature, longer treatment is necessary to achieve continence.

There have been two pilot studies: a Canadian clinical trial and one at Ohio State University with 87% success & 95% improvement rate in both studies. There are two current studies that maintain the previous studies. A retrospective chart review of 3 treatment centers to be published. A prospective review to be presented at the 1999 ACOG meeting.

References
1) Reilley SF, Treatment of Urinary Incontinence using behavioral techniques, Obstet and Gynecol 1999 April;93(4):535
2) Borcier A. Conservative treatment of stress incontinence, Abstract presented at American Urogynecology Society Meeting. Cambridge, Mass. September 1992.
3) Elia G, Bergman A. Pelvic muscle exercises: when do they work? Obstet Gynecol 1993 Feb;81(2):283-86.
4) Burgio KL, Robinson JC, Engel BT. Role of biofeedback in Kegel exercises training for stress incontinence. Am J Obstet Gynecol 1986;154(1):58-64.
5) McDowell BJ, Burgio KL, Dombrowsik M, Locher JL, Rodriquez E. An interdisciplinary approach to the assessment and behavioral treatment of urinary incontinence in geriatric outpatients. J Am Geriatr Soc 1992;40:370.
6) Cammu H, Van Nulen J, Derde MP, DeBruyne R, Amy JJ. Pelvic physiotherapy in genuine urinary stress incontinence. Urology 1991 Oct;38(4):332.
7) Mouritsen L, Frimodt MG, Moller M, Long-term effect of pelvic floor muscle exercises on female UI. Br J Urol 1991;68(1):32-7.
8) Bo K, Hagen RM, Kvarstein B, Jorgensen J, Larsen S. Pelic floor muscle exercises for the treatment of female stress incontinence III. Effects of two different degrees of pelvic floor muscle exercises. Neurourolo Urodyn 1990;9(5):489-502.
9) Clinical Practice Guideline, Number 2, 1996 Update. Urinary Incontinence in Adults: Acute and Chronic Management. US Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research. AHCPR Publication No 96-0682.
10) Era III Medical, Ltd. A report on the clinical efficacy of Incon Therapy on the treatment of urinary incontinence. Era III Medical, Ltd. Incon Therapy. A revolutionary New Treatment for the incontinent population 1996 Feb 26, 10-18.