So can you tell us a bit about the different probes and
electrodes that the Kegel8 uses
and how women might find
a different probe would be better for them, what's
your thoughts on that?
Can you see how similar they all are? They're all trying to do the same thing which is to
deliver the electrical current as close to
the belly of the muscle as possible, so that it can pick
up the nerves that make the muscle work.
So you can see that they've got these
bars side to side.
They all look
quite similar because inside, the shape of the vagina
as you go in, it goes wider more than higher
and the muscles are on - the belly of the muscles is mainly on
the side. So this one was designed first,
when they moved from having very long
ones to small ones, this is the first one that came.
It's nice and light
and simple and the bars are on either side.
And what I like about it is that
it's quite easy to tell if you've got it the right way up.
It's the one that you'll often get in a hospital,
because it's the cheapest one that's available,
you can tell which way is up because you need your cables coming up the top
or out the bottom, they musn't be going side to side.
And it's got a nice little
hook to help pull it in and out, which is good if your hands
struggle with small things.
They left a hole in the top at the beginning
because the idea was that if you had a bit of prolapse,
it would be able to sit into that hole.
But overtime, what we found is that sometimes it pinches a bit,
as people are taking it out. So the difference
between this one and this one is that this one's
got a filled in middle, so it's just as light
and you can tell which way's up because you need the smooth
bar up, and the groovy bits
to the side, and it's got the nice hilt so you can tell if you've
got it in the right distance. But it's got
a filled in middle, so if you've got a bit of prolapse, it will sit there.
Or if you've got a bit of bowel prolapse, it won't push up
and make this move. So they're very similar.
And you're really thinking about prolapse support there
for those two. Something to notice about them as well is
that they're made of stainless steel - the bars.
Now stainless steel is a great conductor,
but it does contain a little bit of nickel, so if you have
a nickel allergy, which you might know from jewelry,
you might find that that's irritating.
So this one is trying to tick all of the boxes,
and you'll see it's gold-plated and
that's because that's less
allergic and would be your choice if you did have a nickel
allergy. It's got a filled-in middle
and it's still lightweight, and it's just got a flatter
structure - the idea being that you could put it under a prolapse
more comfortably, and it's a bit less bulky than those.
And you're calling that 'the bars', the metal bars
but that is also the electrodes, that's where the pulses. Yes, if we're being technical,
that's the electrode, and this is the probe.
But they do tend to get called the electrode or the probe.
But yes, that's where the electricity's got to
move between those two bars.
That's why you have to have your gel on the bars.
And how about the long slim one there?
So this one - the slim one - is what you would use
if you were wanting to do some
stimulation to the anal sphincter and through the back
passage. So it's going to be quite relevant to people with
faecal incontinence, or also if you
had a third or fourth degree tear and you know
that the anal sphincter needs some
rehabilitation as well. It's got a hilt
that moves, so once you know
how far in to put it, you've got this little guide to help you.
This bar is designed to pick up
the sphincter and exercise that.
The slightly deeper bar is to pick up the levator
plate - the pelvic floor muscles further in.
Because it's nice and slim, we also sometimes use
this if we've got somebody with a very small
vagina or who has had a lot of
pain and feels that it can't stretch. This is
a little bit slimmer and friendlier to use
for vaginal stimulation. The only problem would be
that, of course, it could move about more. So it's a little bit of a
play. So they would have to be quite small?
They'd have to be quite small and then keep your knees together
and some of the things we talked about earlier.
But more friendly if you're thinking
'I'm not sure about this'
you know, this would be a nice slim one to try
but could be used in either place. Whereas you can't put these
into the back passage, they're all the wrong shape.
And if someone doesn't want to use an anal or
a vaginal probe, what's the options for them?
Yes so muscle stimulation is
best delivered directly
as close as possible to the muscle and
to where the nerves are.
But before these were invented, it was always delivered using
surface electrodes.
These little sticky pads.
Where you can put them is where
the nerve starts, which is in the spine.
So they can be positioned
round the sacrum, which is the very very low bit
of your spine. It doesn't matter if you're a little bit
higher than where the nerve comes out, because it will still
affect the nerves below. And you can do
that with just two or four
surface electrodes, the machines
will come with the instructions about where to put the electrodes,
the key thing is that there must be a gap between them
because you don't want the electricity to jump from one
to the other. Because you want it to go through and
stimulate the nerve on it's way, so
we usually suggest that you leave the distance of an electrode between
electrodes.
There is one type of stimulation that
we do for the overactive bladder problem
which is the one we talked about about
calming the nerves
and sending lots of sensory nerves and
that can be done through the vaginal electrode
or through sacral placed electrodes
or through putting it near your tibial
nerve which is down by your ankle.
Again, there would be instructions on where to place it.
Or you could do a combination, you could
have a vaginal electrode in position, and
some stimulation on the tibial nerve area as well.
And that's about comfort and
finding out what works for you and whether
you feel you're getting some effect from that.
They're doing lots of research, they're trying to figure out
the best way to do this and
you know, it's still being discovered, but
some people are getting positive results from that
tibial nerve stimulation.
We missed one - this one over here.
This one is one that's called a perisize
and it has a bar that releases
so that you can narrow it to put it in
but once it's in, it widens. So that's
quite ergonomic because that's what
the vagina does inside - the opening is quite small but then it does widen.
So this is good if you're not getting that side to side contact
this one will maybe be a little bit wider
overall, it's the widest you can get.
The other thing about it is
you'll see it's got more cables and that's
because it's sending - it's acting like two
electrodes really. This one is independent
of this one. Now if internally
you've got one side that's more sensitive or
uncomfortable, you might want to have this one on
a lower amplitude - less volume - and this one
higher. Or the opposite way round; you might feel
that actually I need to turn it up more on the right than on the left, I can't
feel it. So you can adjust two sides
separately, which you can't do with these. So it's quite
specialist, it'd be the kind of thing that maybe your
physiotherapist guided you towards, or you
use the basic one first and felt you hadn't
got the width, it wouldn't be a first one to go for.