General questions

Can the tissues heat up too much as a result of PelviPower training?
In general there is no dangerous heating of the tissue. Of course it gets warmer through the training and contraction as the muscle activation generates energy, and also through the increased blood flow. However, this warming effect does not go beyond that of conventional muscle training.
 
No negative effects (including burns of tissue damage) have been described in the scientific literature.
In addition, a 2016 study suggests that RPMS has healing effects on tissue. The study concludes that magnetic stimulation supports the regeneration of muscles and nerves after trauma (Stölting et al, 2016).
________________________________________________________

How long will it take for my client to notice an improvement?
 Most clients notice the effects of PelviPower training relatively quickly. The speed and degree of improvement will of course depend on the client’s complaint or issue and the severity.
 
On average, most clients feel an effect within the first 5 sessions. They often report finding it easier to activate their own pelvic floor or show an improvement in biofeedback (although symptoms may not have improved noticeably yet).
On average we see an improvement in symptoms between the 5th and 10th session.
 
Women with more severe organ prolapse or men who have had a prostatectomy tend to notice improvement on average between 10-20 sessions.
Postpartum women, often feel an improvement in symptoms in the first 5 sessions.
________________________________________________________

Can I support PelviPower training by doing my own exercises?
It is advisable to start doing your own exercises as early as possible. PelviPower™ training enables clients to feel their pelvic floor earlier and more clearly than with conventional exercises. One advantage of this improved awareness of the pelvic floor muscles is that your own practice is likely to be easier and more effective.
________________________________________________________

How long does the effect of the training last?
 Studies on common complaints of a weak pelvic floor (such as incontinence) have shown that the positive effects (reduction or elimination of symptoms after magnetic stimulation training) are still present 1 year after the training is completed.
 
However, there is no clear answer to this question. How long the effects of PelviPower™ last depends on the condition of the user and whether the training is followed by independent training and/or physical activities.
________________________________________________________

How much experience or evidence is there regarding training success using PelviPower magnetic field trainer?
 Pelvic floor training is the first choice for a weak or dysfunctional pelvic floor and is scientifically proven. Classic pelvic floor exercises are recommended for many applications related to pelvic floor dysfunction. Training with the PelviPower is similar to classic pelvic floor muscle training, but with a number of significant benefits. PelviPower™ magnetic field training trains the pelvic floor muscles in a simple, comfortable and effective way.
 
Functional Magnetic Stimulation” (FMS) of the pelvic floor with PelviPower™ is based on the principle of “Repetitive Peripheral Muscle Stimulation (RPMS)”.In the last 10 years, much new research has been conducted in this field and the results show that FMS and RPMS are an effective form of training, that can be used in a wide range of populations. In addition, new research has shown that FMS of the pelvic floor is particularly effective for those who do not benefit from pelvic floor exercises alone. This is understandable as there can be barriers to doing pelvic floor exercises alone, such as difficulty in specifically activating the right muscles and difficulty in coordinating muscle groups so that they can work together. All of this can be overcome through FMS of the pelvic floor
________________________________________________________

Can a PelviPower user also do 2 sessions in a row on the PelviPower? Or is that not recommended?
It is not recommended because it can lead to overexertion and does not bring any additional positive effect. Longer sessions than prescribed are only possible in special, medically indicated cases and then only with low frequencies, strengths etc. and only under therapeutic or medical supervision.
As a rule, a training session of 15-25 minutes is optimal for success.
________________________________________________________

Can training with PelviPower cause increased blood pressure?
Please let me know to what extent PelviPower can be traced back to increased blood pressure. Before using PelviPower, my client had normal blood pressure, but since she has been using it for about 11 weeks, her blood pressure has been elevated.
However, after asking her more precisely, I found out that she had had Covid for 2-3 weeks before and that she had also gained weight.
Increased blood pressure is not observed in the studies. A hypertension induced by magnetic field training is also not comprehensible from a medical point of view. There are many other reasons for increased blood pressure, including weight gain and it has been described as a reaction after Covid. Approximately 85% of all hypertension is so-called essential hypertension, i.e. without an identifiable cause.
________________________________________________________

Can an elevated resting heart rate (106) two hours after exercise be related to PelviPower?
These side effects are not a cause for concern. The slightly increased pulse could be explained as follows: it was a muscular workout and this is strenuous for the body, the metabolic products have to be built up through increased blood flow.
However, an increased pulse can have many causes, including stress, or can be multifactorial. Therefore, another cause is more likely.
________________________________________________________

Can someone with chronic prostatitis do PelviPower training?
 Yes, definitely. The treatment of chronic prostatitis includes pelvic floor training. That’s why we expect PelviPower Training to improve the symptoms here.
The research shows positive results with 12 sessions. The clients received 6 sessions, 2 times a week (with a combination of 10 and 50Hz). A significant improvement in symptoms was shown, which remained at 24 week follow-up (Kim et al, 2013).
________________________________________________________

Is it possible that a bladder symptom worsens after a PelviPower session or right at the beginning of the training wave (1-5 treatments)?
It is possible that there is an initial worsening within the first 10 treatments. This is because the pelvic floor, which is already weak, is now being put under additional strain by the training. However, this gives the muscles a positive impulse to build up, which only happens during the rest phase.
 
A good analogy is: “If you do strength training, e.g. push-ups, you cannot do the same number of push-ups the same day and the next day because the muscles are exhausted. Also, it may be that the pelvic floor was hypertensive and has now become normotensive again because of the stimulation; here it has to get used to the new situation again.”
________________________________________________________

Can PelviPower be used preventively? The interested client can activate her pelvic floor well and has carried out classic PFM training in the past. She does have to go to the toilet at night, but has no other symptoms. She wants to try PelviPower as a preventive measure.
There are many clients who do preventive training with PelviPower. The frequency of the sessions they do in this case is flexible. Therefore, it is advisable to consider the client’s preferences.
            a) For example, a short but intensive training that increases strength and endurance is useful preventively. (e.g. 1-2 times per week – 10 sessions).
            b) On the other hand, in preventive cases, because the pelvic floor already has a higher level of function, it is also possible to leave a little more distance between sessions and still achieve a positive effect. It is recommended that the client carries out at least 5 training sessions with a regularity of 1+ x per week (to achieve an initial muscle-building effect) and then have the possibility to reduce the regularity for maintenance (e.g. 2 weeks apart).
________________________________________________________

Functional strength training before or after PelviPower training?
In general, functional strength training (focusing on the pelvic floor) is better before the PelviPower session. However, this is not always essential (see below):
 
Clients who have a lower initial level of PFM strength clearly have a “tired” pelvic floor after a PelviPower session and are not able to perform endurance training effectively. This is clearly evident during conscious pelvic floor training with the bio-feedback trainer when performed after a PelviPower session, as opposed to before. For this client group it is therefore recommended to do the additional pelvic floor training before the PelviPower session OR on another seperate occasion.
 
For higher function clients it is still possible to do training afterwards and it is NOT counterproductive. However, training before the PelviPower session could still be an option here, as there is the added benefit that the carrying out the PelviPower session afterwards brings additional relaxation effects to the muscles (for example, the training could reduce the likelihood of muscle soreness if done afterwards).
________________________________________________________

A woman who came for a trial session today had light bleeding afterwards. However, she normally no longer has menstruation because of her IUD.
In principle, menstrual bleeding can also occur despite the IUD. One possible explanation ist that the magnetic field training could increase these bleedings because of the contractions.
However, in this case, we would always recommend a check-up with a gynaecologist and a check of the position of the IUD.
________________________________________________________

A client has light bleeding after training. She no longer gets her period. What could be the reason for this?
Bleeding after the menopause should always be clarified by a gynaecological specialist. This could be uterine fibroids, for example, which have now led to bleeding due to the contractions.
________________________________________________________

Are bleeding haemorrhoids or anal fissures a problem with PelviPower training?
PelviPower is not dangerous for haemorrhoids and anal fissures. However, if the haemorrhoids or anal fissures are larger or bleeding, it is better to take a break as the contractions could increase the discomfort.
In addition, the discomfort should improve in the long term, as it is usually caused by an overactive sphincter. The overactive sphincter should be strengthened by the magnetic stimulation, which should also have a preventive effect in the long term. 
In practice, it is advisable to explain to the client the possibility of discomfort and ask how it feels. Then make adjustments to avoid pain during the sessions. E.g. if necessary change the position of the coil or the intensity to a lower setting to ensure a pain-free session.
For small tears, PelviPower can even increase circulation and promote healing.
________________________________________________________

Does Pelvipower help with faecal incontinence due to sphincter injury in people who have suffered an anal sphincter injury?
Sabbour and Shaffik (2009) have shown that RPMS is more effective than PFMT alone for faecal incontinence following sphincter injury.  This study was conducted on fifty volunteer premenopausal women who were still experiencing symptoms of faecal incontinenceafter obstetric injury 12 weeks after their last delivery.
In addition, the anal sphincter is part of the pelvic floor and can also be trained by magnetic field training. It certainly depends on how big the injury to the anal sphincter is, but in general an improvement can be expected
________________________________________________________

Can haemorroids be triggered or caused by PelviPower?
As with conventional pelvic floor training, haemorrhoids are not caused or triggered. PelviPower increases blood flow, so it is possible, though unlikely, that pre-existing haemorrhoids will bleed a little more as a result.
________________________________________________________

Does PelviPower help against chronic constipation?
If the cause of the constipation is a disturbed voiding reflex due to pelvic floor weakness with or without rectal prolapse, then magnetic field training helps well against this form of constipation.
With all other forms of constipation (medication-induced, lifestyle – little fluid intake, little exercise, other illnesses), magnetic field training does not tend to improve constipation.
________________________________________________________

If PelviPower acts on the nerve and it is damaged, is there a possibility that the nerve will start to function again? For example, in a client with an injury to the pudendal nerve after childbirth and a complete lack of sensation in the vagina, can PelviPower help to regenerate this nerve?
Nerve damage (e.g. after childbirth) is not a contraindication for the use of PelviPower.

– If there is local nerve damage (e.g. damage to the pudendal nerve), the training can help to improve the perception of the pelvic floor, and regardless of the “nerve damage”, the muscles are stimulated and treated.

– However, it is recommended to start the training at a lower intensity and gradually increase it through feedback from session to session, especially if the client cannot feel their pelvic floor well. The goal then, of course, is for the client to feel and control the pelvic floor better as the training progresses.

– Research also suggests that RPMS can help with nerve regeneration (Stölting et al., 2016
________________________________________________________

To what extent can PelviPower be helpful in endometriosis?
Jorgensen et al. (1994) showed a positive effect, in particular a significant reduction in pain from various gynaecological causes, including endometriosis and dysmenorrhoea: pain was significantly reduced after 1-3 sessions in 90% of cases. The production of prostaglandins in the uterus has been identified as a mechanism underlying dysmenorrhoea, as they trigger cramps and ischaemia. The higher progesterone levels in the magnetic stimulation group are probably responsible for the reduced menstrual pain, as progesterone inhibits prostaglandin synthesis.

It is scientifically recognised that women with endometriosis have an increased likelihood of pelvic floor dysfunction. Fraga et al (2021) found that women with endometriosis were more likely to have pelvic pain and pelvic floor muscle dysfunction than a control group. Pain was also associated with pelvic floor hypertonicity and difficulty relaxing the pelvic floor muscles. In this area, we see good success in helping clients who either have hypertonic pelvic floor muscle activation or have difficulty relaxing (which can also be seen objectively on during bio-feedback training).
________________________________________________________

How long after a prostatectomy do you stay on the special ‚prostatectomy‘ programme, or after how long can you switch to a rehabilitation programme? Or not at all?
On average, clients can use PelviPower as early as 6-8 weeks after a prostatectomy and need about 20 sessions. This particular group of clients takes a little longer on average for rehab. Within these 20 sessions, one can switch from the special ‚prostatectomy‘ programme (PROSTATECTOMY) to a stronger training programme. When to do this depends on the patient. Examples and recommendations are given below:

If a client comes soon after their prostatectomy (i.e. 2-3 months), then I always recommend starting with the PROSTATECTOMY programme.
If a client has symptoms (e.g. incontinence etc.) then we would stay with the PROSTATECTOMY programme for an average of 10 sessions and then move onto a stronger exercise programme (which includes the 50 Hz) for the following 10 sessions.
 
Possible programmes for progression:
You have a number of programmes to choose from here:
 
– As you said, you can choose the REHABILITATION PROGRAMME.
 – Another good programme is MIXED INCONTINENCE, as it offers a good rangeof frequencies to strengthen and promote circulation.
– A third option, especially for erection problems, is the POTENCY HYPOTON programme. Again, there is a good mix of frequencies, including the higher frequencies. The higher frequencies are needed to increase blood flow, which is necessary for erection problems.
 
PLEASE NOTE: There are also cases of clients who have had major surgery or have more severe symptoms where I would keep the PROSTATECTOMY programme for all 20 sessions as it is the right level for them. To judge this, you have to ask the client for their feedback during and after the session.
 
If a client has very few symptoms and does not show strong reactions during or after the first sessions of the PROSTATECTOMY programme (e.g. no muscle soreness after the sessions). Then you can continue earlier (programme change). For example, after 5 sessions. We recommend trying a new programme and asking participants to give you feedback on how they felt afterwards. A gradual increase in intensity is still recommended. 
 
If a client comes to you much later after prostatectomy (e.g. after 7 months) and their symptoms are mild, you can  use your reasoning to start with a stronger exercise programme or switch from the PROSTATECTOMY programme earlier. However, with these clients it is always good to ask them about their reactions and adjust the programme and intensity accordingly
________________________________________________________

Can the tissues heat up too much as a result of PelviPower training?
In general there is no dangerous heating of the tissue. Of course it gets warmer through the training and contraction as the muscle activation generates energy, and also through the increased blood flow. However, this warming effect does not go beyond that of conventional muscle training.
 
No negative effects (including burns of tissue damage) have been described in the scientific literature.
In addition, a 2016 study suggests that RPMS has healing effects on tissue. The study concludes that magnetic stimulation supports the regeneration of muscles and nerves after trauma (Stölting et al, 2016).
________________________________________________________

How long will it take for my client to notice an improvement?
Most clients notice the effects of PelviPower training relatively quickly. The speed and degree of improvement will of course depend on the client’s complaint or issue and the severity.
 
On average, most clients feel an effect within the first 5 sessions. They often report finding it easier to activate their own pelvic floor or show an improvement in biofeedback (although symptoms may not have improved noticeably yet).
On average we see an improvement in symptoms between the 5th and 10th session.
 
Women with more severe organ prolapse or men who have had a prostatectomy tend to notice improvement on average between 10-20 sessions.
Postpartum women, often feel an improvement in symptoms in the first 5 sessions.
________________________________________________________

Can I support PelviPower training by doing my own exercises?
It is advisable to start doing your own exercises as early as possible. PelviPower™ training enables clients to feel their pelvic floor earlier and more clearly than with conventional exercises. One advantage of this improved awareness of the pelvic floor muscles is that your own practice is likely to be easier and more effective.
________________________________________________________

How long does the effect of the training last?
 Studies on common complaints of a weak pelvic floor (such as incontinence) have shown that the positive effects (reduction or elimination of symptoms after magnetic stimulation training) are still present 1 year after the training is completed.
 
However, there is no clear answer to this question. How long the effects of PelviPower™ last depends on the condition of the user and whether the training is followed by independent training and/or physical activities.
________________________________________________________

How much experience or evidence is there regarding training success using PelviPower magnetic field trainer?
Pelvic floor training is the first choice for a weak or dysfunctional pelvic floor and is scientifically proven. Classic pelvic floor exercises are recommended for many applications related to pelvic floor dysfunction. Training with the PelviPower is similar to classic pelvic floor muscle training, but with a number of significant benefits. PelviPower™ magnetic field training trains the pelvic floor muscles in a simple, comfortable and effective way.
 
Functional Magnetic Stimulation” (FMS) of the pelvic floor with PelviPower™ is based on the principle of “Repetitive Peripheral Muscle Stimulation (RPMS)”.In the last 10 years, much new research has been conducted in this field and the results show that FMS and RPMS are an effective form of training, that can be used in a wide range of populations. In addition, new research has shown that FMS of the pelvic floor is particularly effective for those who do not benefit from pelvic floor exercises alone. This is understandable as there can be barriers to doing pelvic floor exercises alone, such as difficulty in specifically activating the right muscles and difficulty in coordinating muscle groups so that they can work together. All of this can be overcome through FMS of the pelvic floor
________________________________________________________

Can a PelviPower user also do 2 sessions in a row on the PelviPower? Or is that not recommended?
It is not recommended because it can lead to overexertion and does not bring any additional positive effect. Longer sessions than prescribed are only possible in special, medically indicated cases and then only with low frequencies, strengths etc. and only under therapeutic or medical supervision.
As a rule, a training session of 15-25 minutes is optimal for success.
________________________________________________________

Can training with PelviPower cause increased blood pressure?
Please let me know to what extent PelviPower can be traced back to increased blood pressure. Before using PelviPower, my client had normal blood pressure, but since she has been using it for about 11 weeks, her blood pressure has been elevated.
However, after asking her more precisely, I found out that she had had Covid for 2-3 weeks before and that she had also gained weight.
Increased blood pressure is not observed in the studies. A hypertension induced by magnetic field training is also not comprehensible from a medical point of view. There are many other reasons for increased blood pressure, including weight gain and it has been described as a reaction after Covid. Approximately 85% of all hypertension is so-called essential hypertension, i.e. without an identifiable cause.
________________________________________________________

Can an elevated resting heart rate (106) two hours after exercise be related to PelviPower?
These side effects are not a cause for concern. The slightly increased pulse could be explained as follows: it was a muscular workout and this is strenuous for the body, the metabolic products have to be built up through increased blood flow.
However, an increased pulse can have many causes, including stress, or can be multifactorial. Therefore, another cause is more likely.
________________________________________________________

Can someone with chronic prostatitis do PelviPower training?
Yes, definitely. The treatment of chronic prostatitis includes pelvic floor training. That’s why we expect PelviPower Training to improve the symptoms here.
The research shows positive results with 12 sessions. The clients received 6 sessions, 2 times a week (with a combination of 10 and 50Hz). A significant improvement in symptoms was shown, which remained at 24 week follow-up (Kim et al, 2013).
________________________________________________________

Is it possible that a bladder symptom worsens after a PelviPower session or right at the beginning of the training wave (1-5 treatments)?
It is possible that there is an initial worsening within the first 10 treatments. This is because the pelvic floor, which is already weak, is now being put under additional strain by the training. However, this gives the muscles a positive impulse to build up, which only happens during the rest phase.
 
A good analogy is: “If you do strength training, e.g. push-ups, you cannot do the same number of push-ups the same day and the next day because the muscles are exhausted. Also, it may be that the pelvic floor was hypertensive and has now become normotensive again because of the stimulation; here it has to get used to the new situation again.”
________________________________________________________

Can PelviPower be used preventively? The interested client can activate her pelvic floor well and has carried out classic PFM training in the past. She does have to go to the toilet at night, but has no other symptoms. She wants to try PelviPower as a preventive measure.
There are many clients who do preventive training with PelviPower. The frequency of the sessions they do in this case is flexible. Therefore, it is advisable to consider the client’s preferences.
            a) For example, a short but intensive training that increases strength and endurance is useful preventively. (e.g. 1-2 times per week – 10 sessions).
            b) On the other hand, in preventive cases, because the pelvic floor already has a higher level of function, it is also possible to leave a little more distance between sessions and still achieve a positive effect. It is recommended that the client carries out at least 5 training sessions with a regularity of 1+ x per week (to achieve an initial muscle-building effect) and then have the possibility to reduce the regularity for maintenance (e.g. 2 weeks apart).
________________________________________________________

Functional strength training before or after PelviPower training?
In general, functional strength training (focusing on the pelvic floor) is better before the PelviPower session. However, this is not always essential (see below):
 
Clients who have a lower initial level of PFM strength clearly have a “tired” pelvic floor after a PelviPower session and are not able to perform endurance training effectively. This is clearly evident during conscious pelvic floor training with the bio-feedback trainer when performed after a PelviPower session, as opposed to before. For this client group it is therefore recommended to do the additional pelvic floor training before the PelviPower session OR on another seperate occasion.
 
For higher function clients it is still possible to do training afterwards and it is NOT counterproductive. However, training before the PelviPower session could still be an option here, as there is the added benefit that the carrying out the PelviPower session afterwards brings additional relaxation effects to the muscles (for example, the training could reduce the likelihood of muscle soreness if done afterwards).
________________________________________________________

A woman who came for a trial session today had light bleeding afterwards. However, she normally no longer has menstruation because of her IUD.
In principle, menstrual bleeding can also occur despite the IUD. One possible explanation ist that the magnetic field training could increase these bleedings because of the contractions.
However, in this case, we would always recommend a check-up with a gynaecologist and a check of the position of the IUD.
________________________________________________________

A client has light bleeding after training. She no longer gets her period. What could be the reason for this?
Bleeding after the menopause should always be clarified by a gynaecological specialist. This could be uterine fibroids, for example, which have now led to bleeding due to the contractions.
________________________________________________________

Are bleeding haemorrhoids or anal fissures a problem with PelviPower training?
PelviPower is not dangerous for haemorrhoids and anal fissures. However, if the haemorrhoids or anal fissures are larger or bleeding, it is better to take a break as the contractions could increase the discomfort.
In addition, the discomfort should improve in the long term, as it is usually caused by an overactive sphincter. The overactive sphincter should be strengthened by the magnetic stimulation, which should also have a preventive effect in the long term. 
In practice, it is advisable to explain to the client the possibility of discomfort and ask how it feels. Then make adjustments to avoid pain during the sessions. E.g. if necessary change the position of the coil or the intensity to a lower setting to ensure a pain-free session.
For small tears, PelviPower can even increase circulation and promote healing.
________________________________________________________

Does Pelvipower help with faecal incontinence due to sphincter injury in people who have suffered an anal sphincter injury?
Sabbour and Shaffik (2009) have shown that RPMS is more effective than PFMT alone for faecal incontinence following sphincter injury.  This study was conducted on fifty volunteer premenopausal women who were still experiencing symptoms of faecal incontinenceafter obstetric injury 12 weeks after their last delivery.
In addition, the anal sphincter is part of the pelvic floor and can also be trained by magnetic field training. It certainly depends on how big the injury to the anal sphincter is, but in general an improvement can be expected
________________________________________________________

Can haemorroids be triggered or caused by PelviPower?
As with conventional pelvic floor training, haemorrhoids are not caused or triggered. PelviPower increases blood flow, so it is possible, though unlikely, that pre-existing haemorrhoids will bleed a little more as a result.
________________________________________________________

Does PelviPower help against chronic constipation?
If the cause of the constipation is a disturbed voiding reflex due to pelvic floor weakness with or without rectal prolapse, then magnetic field training helps well against this form of constipation.
With all other forms of constipation (medication-induced, lifestyle – little fluid intake, little exercise, other illnesses), magnetic field training does not tend to improve constipation.
________________________________________________________

If PelviPower acts on the nerve and it is damaged, is there a possibility that the nerve will start to function again? For example, in a client with an injury to the pudendal nerve after childbirth and a complete lack of sensation in the vagina, can PelviPower help to regenerate this nerve?
Nerve damage (e.g. after childbirth) is not a contraindication for the use of PelviPower.

– If there is local nerve damage (e.g. damage to the pudendal nerve), the training can help to improve the perception of the pelvic floor, and regardless of the “nerve damage”, the muscles are stimulated and treated.

– However, it is recommended to start the training at a lower intensity and gradually increase it through feedback from session to session, especially if the client cannot feel their pelvic floor well. The goal then, of course, is for the client to feel and control the pelvic floor better as the training progresses.

– Research also suggests that RPMS can help with nerve regeneration (Stölting et al., 2016
________________________________________________________

To what extent can PelviPower be helpful in endometriosis?
Jorgensen et al. (1994) showed a positive effect, in particular a significant reduction in pain from various gynaecological causes, including endometriosis and dysmenorrhoea: pain was significantly reduced after 1-3 sessions in 90% of cases. The production of prostaglandins in the uterus has been identified as a mechanism underlying dysmenorrhoea, as they trigger cramps and ischaemia. The higher progesterone levels in the magnetic stimulation group are probably responsible for the reduced menstrual pain, as progesterone inhibits prostaglandin synthesis.

It is scientifically recognised that women with endometriosis have an increased likelihood of pelvic floor dysfunction. Fraga et al (2021) found that women with endometriosis were more likely to have pelvic pain and pelvic floor muscle dysfunction than a control group. Pain was also associated with pelvic floor hypertonicity and difficulty relaxing the pelvic floor muscles. In this area, we see good success in helping clients who either have hypertonic pelvic floor muscle activation or have difficulty relaxing (which can also be seen objectively on during bio-feedback training).
________________________________________________________

How long after a prostatectomy do you stay on the special ‚prostatectomy‘ programme, or after how long can you switch to a rehabilitation programme? Or not at all?
On average, clients can use PelviPower as early as 6-8 weeks after a prostatectomy and need about 20 sessions. This particular group of clients takes a little longer on average for rehab. Within these 20 sessions, one can switch from the special ‚prostatectomy‘ programme (PROSTATECTOMY) to a stronger training programme. When to do this depends on the patient. Examples and recommendations are given below:

If a client comes soon after their prostatectomy (i.e. 2-3 months), then I always recommend starting with the PROSTATECTOMY programme.
If a client has symptoms (e.g. incontinence etc.) then we would stay with the PROSTATECTOMY programme for an average of 10 sessions and then move onto a stronger exercise programme (which includes the 50 Hz) for the following 10 sessions.
 
Possible programmes for progression:
You have a number of programmes to choose from here:
 
– As you said, you can choose the REHABILITATION PROGRAMME.
 – Another good programme is MIXED INCONTINENCE, as it offers a good rangeof frequencies to strengthen and promote circulation.
– A third option, especially for erection problems, is the POTENCY HYPOTON programme. Again, there is a good mix of frequencies, including the higher frequencies. The higher frequencies are needed to increase blood flow, which is necessary for erection problems.
 
PLEASE NOTE: There are also cases of clients who have had major surgery or have more severe symptoms where I would keep the PROSTATECTOMY programme for all 20 sessions as it is the right level for them. To judge this, you have to ask the client for their feedback during and after the session.
 
If a client has very few symptoms and does not show strong reactions during or after the first sessions of the PROSTATECTOMY programme (e.g. no muscle soreness after the sessions). Then you can continue earlier (programme change). For example, after 5 sessions. We recommend trying a new programme and asking participants to give you feedback on how they felt afterwards. A gradual increase in intensity is still recommended. 
 
If a client comes to you much later after prostatectomy (e.g. after 7 months) and their symptoms are mild, you can  use your reasoning to start with a stronger exercise programme or switch from the PROSTATECTOMY programme earlier. However, with these clients it is always good to ask them about their reactions and adjust the programme and intensity accordingly
________________________________________________________

Does PelviPower help with nocturnal incontinence. E.g. bedwetting at night (without incontinence during the day), in an adult?
The question is always what is the cause of the nocturnal urine loss. If the cause is stress/urge or mixed incontinence, then PelviPower training can help. But if it is only at night, then it is very unlikely.
 
Alternative possible causes can be manifold (diabetes insiüidus, neurological disorders, psychogenic, …). In this case, strengthening the pelvic floor is not expected to improve the situation because it is not the cause of the problem. Our recommendation is to send the client to the doctor who is treating him/her with the question whether an improvement can be expected by strengthening the pelvic floor
_________________________________________________________

Can thrombosis be triggered by the magnetic field or is the risk perhaps even reduced (if one is prone to thrombosis)?
No increased incidence of thrombosis was observed in the studies. From a medical point of view, this is also not to be expected:
 
The so-called Virchow triad describes the causal factors for the development of thromboses:
 
1.      changes in the vessel walls (endothelial damage)
2.     changes in the flow velocity (hypocirculation, or stasis)
3.      changes in the composition of the blood (hypercoagulability).
Magnetic field training does not lead to a worsening of these three factors.
_________________________________________________________

After a trial session with PelviPower, my tinnitus seemed to get louder. Could this be a side effect? Or could it be related to it?
A connection between tinnitus and PelviPower pelvic floor training can be ruled out, partly because the affected area is too far away.
 
At most, in the case of tinnitus of unclear origin, it can happen that multifactorial and absolutely subjective factors ( e.g. an event perceived as stress) can lead to a changed tinnitus perception. However, a connection with the PelviPower pelvic floor training cannot be objectively explained.
_________________________________________________________

Contraindication questions

I would like to get pregnant and prepare my pelvic floor muscles for it. Can I use PelviPower MFT?
As long as you use the MFT, you should use contraception. This is because it is always a contraindication if you are pregnant, no matter how advanced.
 
If you are “actively” planning, i.e. no longer using contraception, only the bio-feedback trainer comes into question.
________________________________________________________

Can women who have a copper or gold IUD use PelviPower. Is this an absolute contraindication, or can they opt for the MFT or ask their gynaecologist for clarification?
Copper and gold are not ferromagnetic, so there is no risk here. There is a study from 2019 (Neumann et al, 2019) that tested copper IUDs and showed that there is no risk of heating. In most cases, the gold coils are made of a gold-copper alloy, so there should be no risk here either.
 
Therefore, patients can be safely treated with copper or gold coils. However, we must point out that the position of these can theoretically slip and thus adequate contraception is not guaranteed. We therefore recommend other contraceptive methods throughout the duration of PelviPower useage and a position check with the gynaecologist after completion of the training block.
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Is a knee replacement a contraindication. What about a patella replacement?
Knee replacements are not a contraindication. It is only when a metal extension (nail) protrudes into the thigh bone that  it will be affected by the magnetic field.
Therefore, it is necessary to always point out that no metal should be present further than approx. 10 cm above the knee.
E.g. If it is a normal knee replacement (TKR), it is not a problem. Also, a partial prosthesis or a patella replacement are no problem.
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Is a titanium hip contraindicated?  
Yes. This is a contraindication. The stem in the femur is made of a titanium compound which unfortunately can heat up.
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Can someone with Neobladder use PelviPower?
Yes, PelviPower can be used with NeoBladder as long as the surgery has not been recent (e.g. not < 8 weeks). It is recommended to start gently and see how it goes until the next session.
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A lady had an intervertebral disc operation 3 months ago but without plates, only the core of the disc that was pressing out was removed. Can she use PelviPower?
That is not a problem.
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Can someone with Crohn’s disease use PelviPower?
Yes, no problem.
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Can you use PelviPower with a broken arm?
In principle, there is no problem using PelviPower with a broken arm.
We advise waiting the usual 6 weeks after the operation. We do not want any complications from other causes to be associated with the training. This is however purely a precautionary measure.

If training is desired prior to this, we recommend that the arm be placed to the side of the chair, e.g. on a small table. In this position (on an armrest), the arm is also outside the magnetic field.
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Can you use the PelviPower if you have stents?
A distinction must be made here: Stents that are not within the range of the magnetic field, e.g. in the coronary arteries, are not a problem if the operation was performed more than 8 weeks ago and they have grown in.

Stents that are made of metal and lie in the area of activation, e.g. in the pelvic arteries, are contraindicated (metal in the pelvis, lumbar spine area).
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What exactly does the term decompensated heart disease/cardiac arrhythmia mean? Who is not allowed to use the magnetic field?
Decompensated heart disease means that:
a)     the client has a diagnosis of heart disease, e.g. heart failure, arrhythmia, chronic coronary syndrome, etc., and is currently acute.
b)     The client also has acute symptoms because of it, e.g. leg or lung oedema, shortness of breath, angina, etc.
However, if the client is well adjusted to the medication, i.e. their condition has been stable for weeks, and they do not currently or recently need medical treatment, then their heart condition is compensated and therefore they can undergo ‚PelviPower‘ training, as long as there are no other contraindications. In case of doubt, you should consult with the attending physician or with us.
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Can the following client example use PelviPower or is training contraindicated?: A client who had a heart attack 4 years ago and now has an extrasystole. He is taking a small dose of BetaBlocker (Bisoprolol San Ftbl 5mg 1/4).
In this case, treatment with PelviPower is not a problem.
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Can you explain how PelviPower can trigger an epilepsy seizure?
Epilepsy is contraindicated with all electrostimulation and magnetic stimulation devices. In theory, it could trigger an epileptic seizure because the magnetic stimulation induces an electric field which leads to potential shifts and thus to depolarisation of the peripheral nerves. This leads to a return current to the CNS (brain) which also leads to an excitation there, which we also hope for because it brings improved perception and control of the pelvic floor. However, precisely this excitation in the CNS carries the risk of triggering an epileptic seizure.
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If someone is taking epilepsy medication for seizure prophylaxis but has never had a seizure, can they use PelviPower?
If the client doesn’t have seizures, but just talks about ‘seizure prophylaxis’, PelviPower is not a problem.
 
If he/she has never had a seizure, not even a small local seizure, then it is no problem to train with PelviPower. However, if the doctor has diagnosed epilepsy, this is a formal contraindication.
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A client who suffers with polyneuraligia had a strong reaction with severe tingling and dizziness and high blood pressure after the session. Is this the reason for her reaction? Is it likely that fibromyalgia is also a problem when using PelviPower?
Neither polyneuropathy nor fibromyalgia are likely to cause side effects and they are not contraindiciated. The described symptoms may be an indiciation of a panic attack (in the initial stage).
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For clients who have extreme reactions to the Pelvi session (toe and finger tips move and tingle, eyelids move and heart palpitations after use) are further sessions recommended?
This sounds very much like a stress/panic attack if there is tingling in the fingers and heart palpitations. One would of course need to know more to be able to assess this better.
The following measures are important to consider in this case:
Firstly, it is very important to have a reassuring and calming effect on the client and explain to him/her that nothing can happen.
If clients are sensitive to level 1, either with pain or other reactions, you can also get them used to PelviPower at a lower intensity by placing a towel under them. The more folds, the less intense it is felt.  Also, the treatment is felt less intensely when the chair is in a reclined position. This allows the client time to adjust to the treatment while feeling more relaxed and comfortable.
If the toes only react on one side, it can help to suggest the client moves a little to the side that reacts more as this shift in position typically reduces the reaction of the nerve in the leg. Although this toe reaction is no problem and reassurance can also be given, it can worry the client or be uncomfortable, so movement to reduce it can also be desirable. 
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Can PelviPower be used directly after a thyroidectomy?
Yes, it is not a problem
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Is hyperthyroidism an absolute contraindication for the use of PelviPower? I have heard that hyperthyroidism is contraindicated for MRI.
Hyperthyroidism is not an absolute contraindication. Usually, clients with hyperthyroidism are on medication, so they have a balanced metabolism and therefore no symptoms.
 
MRI/CT uses a contrast medium containing iodine, so that the thyroid gland must be shielded with medication. However, this is not the case with magnetic field training and therefore does not pose a problem.
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Does an insulin meter on the upper arm also count as a contraindication?
An insulin meter is not a contraindication. It is also not in the effective range oft he magnetic field.
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Are normal (removable) hearing aids a contraindication for the use of the magnetic field? Or do they have to be removed for the session?
Hearing aids are outside the effective range of the magnetic field. However, we recommend to take them off if possible to avoid any influence on the batteries.
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Is there anything to consider with regard to a Bladder band (sling operation)?
Since no metal is used here, we do not see any problem.
The surgery should be over 8 weeks ago and we recommend starting very gently and watching from session to session that it is well tolerated.
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Can the PelviPower also be used with a stoma? The potential customer has had a stoma for 30 years. 
A stoma, i.e. an ileostomy, is not a contraindication. It is not a problem to use the PelviPower.
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Can a client with paraplegia use PelviPower?
In principle, PelviPower training can also be carried out with paraplegia. Please be aware of any metal implants or braces in the field of action, as these would be contraindicated.
 
As the person can only give limited feedback, it is advisable to stay at a lower intensity and only increase slowly after repeated sessions.
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Is a mesh for bladder or hernia repair a contraindication for PelviPower?
In Lichtenstein or laparoscopic hernia operations where a mesh is inserted, you can move around and get up the very next day and then increase activity in a manner according to how to pain is. But sport is only recommended when the mesh has grown in, which is after 4-8 weeks. This is quicker with the laparoscopic operation than with the Lichtenstein operation.
 
Therefore, we would also recommend here, as we have done so far, to start only after 8 weeks.  If therapy is desired before this point, then the approval of the treating Physician is required
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Is a mechanical heart valve a contraindication?
It is not a contraindication. But one should carry out the training in a reclined lying down position and not sitting. This avoids the heart being directly above the magnetic field
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A customer wears so-called “LONGO braces” after an intestinal operation. Can she use the Pelvipower?
As long as the Longo staples have a rather low volume and are made of titanium, we would not expect any heating and also no electrocorrosion – a guarantee, tests with exactly the staples would require.
We would advise caution, use low intensity and only when stable wound healing and ingrowth of the staples is assured, not a short time after surgery as the surgical area is quite in the centre of the strongest field. The client should also be advised to be aware of any altered sensory perceptions in the area.
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Is PelviPower safe to use after sterilisation? The most commonly used clips in the UK are the Filshie clips, which contain titanium.
 
The Filshie Clips are of a similar size and material to the LONGO clips. Therefore, neither should pose a danger as they are so small and do not heat up much. The above answer with additional notes on LONGO clips therefore applies to both LONGO clips and Filshie clips
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At what vertebra are screws generally a contraindication? An potential client has screws in the L5/S1. Is PelviPower contraindicated?
An exact limit cannot be defined due to the different constitution of the patients. What we can say for sure is that screws in the cervical spine and upper thoracic region should not be a problem. Here, the chair’s backrest position can also be reclined, so that the upper body is out of the magnetic field.
However, screws in the lumbar spine area, thus in the magnetic field, are a contraindication for the use of PelviPower.
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Can a PelviPower session be carried out for diverticulitis or is there anything to bear in mind here?
 
It is important to distinguish between diverticulosis and diverticulitis. The former are protrusions (small pouches or sacs) that form and push out from the colon and can be completely asymptomatic. However, they can also become inflamed, in which case they are called diverticulitis and often require antibiotic treatment. Clients who have diverticulosis can also suffer from diverticulitis more than once. This is a bacterial infection, which is why I advise against training in the acute stage. It also falls under the relative contraindication “febrile infection”, even if the affected persons, especially older ones, do not necessarily have to have a fever. It is better to wait until the infection has healed before training on the PelviPower.
 
It is important to ask the clients exactly whether they are currently being treated for diverticulitis or whether they have diverticulosis that is harmless.

Technical questions

What can I do if intensity 1 is too high for my client and they are not comfortable?
 
There are many ways to reduce the intensity of the session and make it comfortable for your client. For example:
 
1) Use a folded towel and sit on it…. Fold it as many times as needed to make the stimulation painless and comfortable.
 
2) Make sure the sitting position is a relaxed, reclined position. (Stimulation is felt less intensely when the backrest position is reclined and the feet are supported).
 
3) Move the coil setting away from the painful area. For example, if you have pain in your back, move the coil to the L setting, which is further forward. Or if you are using PelviBack, switch to Pelvitrain with L.
 
4) Reduce to lower frequencies by changing the program (e.g. to PelviVital).
 
5) Reduce the active:pause setting to a lower stimulation (e.g. to 6:4 or 4:4).
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I have a client with a hypertonic (tense) pelvic floor. Can you recommend me a program for pelvic floor relaxation?
 
PelviPower can also help to relax and release a hypertonic pelvic floor. There are three main mechanisms for this:
            (i) lower, gentler frequencies can relax and release muscles.
            ii) Stronger exercise frequencies can also help by strongly activating the muscle and causing it to relax more thoroughly afterwards.
            iii) high frequencies such as 50 Hz can increase blood flow and also have a micro-massage effect.
 
       There are three main methods and corresponding programme choices to release a tight pelvic floor:
 
(a) Use a condition-specific programs that are ideal for relaxation and focus on specific areas.
 
 For example: the Sciatic program (ISCHIALGIE) has an automatic coil position that is located where the piriformis muscle is most affected (which is on average the 15). It starts with a strong concentration on higher frequencies with 5Hz relaxation in between. The order of frequencies is as follows: 10-35-40-45-5-50-5-25-50-5-50-5
This method is particularly good for relaxing the piriformis muscle, and therefore can be used for piriformis syndrome. Or for people with suspected tension in the muscles further back (e.g. obturator internus). Of course, you can also target a different area with this program by manually changing the position of the coil!
 
Another example is POTENCY HYPERTON. The frequency order is as follows: 15-5-25-35-50-5-35-5-50-5, with the longest phases also on the middle to higher frequencies. The position is 32, which is the average “middle” position for the pelvic floor. This can, of course, be adjusted to the person and remain in the manually selected position. These frequencies help to normalize tone. In this case, increasing blood flow is also very important for potency, and the inclusion of strengthening frequencies (e.g. 25) is useful not only for resolving a hypertonic pelvic floor, but also for improving strength and endurance, which are needed in potency training
 
b) Choose a program that focuses on lower, gentler frequencies.
For example: The PROSTATECTOMY program. This program very gradually increases from 5 to 20 Hz. . . 5-10-13-5-15-5-20-5-20
It is a good choice if you want something very gentle. We usually recommend this method when the tense pelvic floor is associated with severe pelvic pain or pain during sexual intercourse. Also, if the person is sensitive, it is best to go with this gentle option here. (At least until she gets used to it).
 
c) The third option is to work with a range of high, low and medium frequencies (see the explanations of the simple mechanism above).
Then the perfect program is MIXED INCONTINENCE (MIK) as it has a good range of low, mid and high frequencies.
This could be a good choice if both pelvic floor relief and strengthening are desired, as there is a more even distribution of frequencies.
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Which program is recommended for prostate enlargement?
We would recommend the URGE INCONTINENCE programme because it has a focus between 5 and 14 Hz. This is also similar to the frequencies seen in research for enlarged prostate
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Who is answering the FAQ?
(the people behind the medical hotline)

“Train your pelvic floor. New. Simple. Effective.“
Dr. Remo Schneider
Founder and visionary
Lives near Zürich, CH
“PelviPower improves pelvic floor muscle function by not only strengthening your muscles, but also effectively improving flexibility & releasing muscle tension.” 
Cleo Barrable MSc
Physiotherapist & pelvic floor specialist
Lives with her family in Vienna
“PelviPower training is an effective and safe treatment for strengthening the pelvic floor.”
Dr. med. Nicolas Peifer-Weiss
Specialist in orthopaedics
Lives with his family in Innsbruck

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