I just received the following comments, which are 
certainly interesting and discussible.  So I have removed
the personal identification information and prepared a 
general response to stimulate discussion here.

> I just wanted to reply to you personally. I was curious, 
> have you tried the magnetic stimulator devise?  

No I haven't.  My comments are based only on what the
promoters have said, and what is known about electrical
stimulation in general in pelvic muscle rehabilitation.

> As far as what they report for convenience,
> and "quality" of the contraction, I would have to agree 
> with their reports.

I have no reason to doubt the accuracy of their reports;
I am merely questioning the meaning of them.  

> As far as patient tolerance, I have doubts as to how well 
> people would tolerate it, but I am sure better than implantable 
> electrodes. 

I would think the patient tolerance would be very good;
after all, you can read a book while getting the treatment;
that's better than an MRI!

> I would agree with your assessment of their outcomes--all 
> "new" technologies cure 85% to 90% of patients and then 
> several months/years later, the actually facts come out that 
> it does not work that well.  

In the USA at least, such claims are well-regulated by the FDA,
but that doesn't stop people from saying things that are 
factually "true" but meaningless.   For obvious example, you
can say "discounts up to 90%" and fool a lot of people because
you haven't said EVERYTHING is 90%, just SOME things.

In the case of NeoControl, as I recall some 47% were "cured",
but there was a wide range of initial problems and it is 
possible that only "mild" problems were actually cured,
so that statistic could be "true" but still relatively meaningless.

Also, when someone reports another 30% of patients had a
50% or greater reduction in symptoms, SO WHAT? 
What is so great about going from 6 pads a day to 3 pads a
day?  If I bought a plane ticket from California to London, 
and they said "Sorry, you'll have to get off in New York",
I would feel very cheated.

Add to that, as you suggest, that in the hands of sloppy
imitators the result are often not as good as initially
reported, and the outlook is dismal.

> In support of the NeoControl, I would bet that it works for 
> those patients who would otherwise respond to electrical 
> stim, but as you note, this is not the
> majority of patients with incontinence.
> 
> Having actually tried the devise (just to see what it felt 
> like, I am not incontinent), I thought I would just give you 
> feedback on how it felt and how well it contracted muscles
> -- very well and very comfortably.

Congratulations on trying it yourself.  I always tell my
(behavioral therapy) students, "do not try anything on patients 
that you haven't tried on yourself first."  I myself have tried
direct electrical stim, and I felt it was weird and unpleasant.

And, it remains a problem that electrical stimulation gets 
only half as effective results as biofeedback.  That's probably
because stim only exercises the muscle itself, not the whole
brain-nerve path-muscle combination that the patient must
eventually learn to exercise and control, if they are to become
continent.    

That's sort of like changing the tires to get better mileage,
when you'd do better to get an entire engine tune-up!

Thanks for your comments.

John D. Perry, PhD
Psychologist - Biofeedback Specialist
(near San Francisco USA)

PS: 
The reference was to a series at:
http://www.incontinet.com/empire.htm




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