EMP Chair Pro – guide to HI-EMP pelvic floor training

The pelvic floor supports the bladder, uterus and bowel, stabilises the spine and controls closure. It can lose strength and coordination due to pregnancies and births, hormonal changes during menopause, surgery, chronic strain (coughing, heavy lifting, overweight) or increasing age.

Risk factors

• –Vaginal births, especially multiple or with a large baby
• –Menopause and oestrogen deficiency
• –Overweight, chronic cough, chronic constipation
• –Connective tissue weakness, genital prolapse
• –Increasing age

Frequency

Roughly one in three women is affected by urinary incontinence at some point in her life; a large proportion benefit from conservative approaches such as pelvic floor training and supplementary electromagnetic stimulation.

Typical symptoms

• –Urine loss during coughing, sneezing, laughing or sport
• –Sudden, hard-to-control urinary urgency
• –Feeling of pressure, heaviness or a foreign body in the pelvis
• –Sensation of incomplete bladder emptying
• –Limitations in intimate life

Common incidental findings

• –Need for recovery after pregnancy and birth
• –Recurrent urinary tract infections with pelvic floor weakness

When is it detected?

The earlier the pelvic floor is targeted for strengthening, the better the prognosis. Assessment is carried out discreetly and systematically.

Before treatment begins, there is an initial medical consultation with Dr. Wagner including history-taking, gynaecological examination and classification of the complaints. You then complete an initial evaluation questionnaire; Viktoria Vlachou, our pelvic floor specialist, carries out a structured assessment – including questions on micturition, pelvic symptoms, bowel function, sexuality and quality of life.

Examinations

• –Medical history, gynaecological examination, ultrasound and post-void residual measurement if indicated
• –Initial evaluation questionnaire and structured assessment by Viktoria Vlachou, pelvic floor specialist
• –Where clinically indicated: vaginal examination of the pelvic floor muscles to assess strength and coordination – also over time to document progress
• –Exclusion of contraindications (pregnancy, pacemaker/implants, acute infection, tumour disease in the treatment area, copper IUD)

What do the findings mean?

The combination of medical assessment and specialist evaluation allows an individual choice of programme and intensity, and a realistic prognosis. Useful combinations (physiotherapy, local oestrogens, pessary, GynEffik® Connect) are planned alongside.

Watchful waiting

In addition to the EMP chair series, you receive pelvic floor exercises for home use. Consistent participation substantially supports the outcome. Over time, at-home electrostimulation with GynEffik® Connect may be recommended (typically three 30-minute sessions per week).

Medication

During and after menopause, local oestrogens markedly improve the mucosa, sensitivity and susceptibility to infection and are often used as a complement. For overactive bladder, anticholinergics or mirabegron may be indicated.

Surgery

For pronounced stress incontinence with insufficient response to conservative therapy, tension-free sub-urethral tapes (TVT/TVT-O) are established and effective. Surgical options are only discussed jointly once conservative therapy has been exhausted.

• –Regular pelvic floor training – especially after births and during menopause
• –Keep weight in a healthy range, treat chronic cough and constipation
• –Use correct technique for heavy lifting, consciously engage the pelvic floor
• –Early assessment at first symptoms – do not wait

• Pelvic floor training EMP Chair Pro – treatment→
• Incontinence→
• Prolapse→
• Vaginal Dryness & CO₂ Laser→
• Menopause→

• ↗SGGG – Schweizerische Gesellschaft für Gynäkologie und Geburtshilfe
• ↗International Continence Society (ICS)
• ↗NICE Guideline NG123 – Urinary incontinence and pelvic organ prolapse in women