Magnetic Chair — Full-Length Doctor’s Interview
What is urgent incontinence, and what causes it?
Dr. Galloway: Urgent incontinence is merely leakage that is associated with a feeling that you need to go to the bathroom, but you can’t quite get there in time. That sort of leakage is usually associated not with a few drops of leakage but a flood. It comes at times when you don’t want it to, when you can’t predict it, when you don’t know it’s going to happen. When it does happen, it’s usually a dramatic and embarrassing event.
Who does this usually affect?
Dr. Galloway: Urgent incontinence can occur in both men and women. It’s more common in women, but it also occurs in children and adolescents.
It’s not something that is exclusively the problem of one particular subset of patients. For some, urgent incontinence is a sign of neurological problems, such as multiple sclerosis or stroke. This therapy is targeted towards stress incontinence rather than urgent incontinence.
What is stress incontinence?
Dr. Galloway: Stress incontinence is the involuntary leakage of urine that occurs in association with events such as coughing, lifting or straining. This sort of leakage often occurs in association with sporting activities such as playing tennis, walking or running.
What causes stress incontinence?
Dr. Galloway: It has a number of causes, but the common root cause of most stress incontinence is due to muscle weakness. That weakness is something that can become a little more obvious as you grow older. It can be made a little worse by events such as vaginal delivery with childbirth, and it can also be made worse by back problems and a whole variety of physical conditions, including being overweight or having a chronic cough.
Who is mainly the target of stress incontinence?
Dr. Galloway: The greatest population suffering with stress incontinence are the ladies of our community, the women. Women are at least 10 times more likely to have stress incontinence than men. The men who have problems with stress incontinence tend to have had prostate surgeries or other surgical treatments. That surgery removes part of the passive continence mechanism and leaves the patient to rely on their muscles for their bladder control.
Tell me about needle control and how it works.
Dr. Galloway: Needle control is a brand new kind of approach to this problem. It uses a classical principle of physics — if we have a rapidly changing magnetic field, it will induce normal electrical current to flow in the adjacent territory. So if we put copper wire and a dynamo, and we move the magnet, it induces electricity to run in the copper. If we put human tissues in the presence of a changing magnetic field, it will induce depolarization of the nerves and the muscles. That will create a natural contraction of the muscles.
Is this safe?
Dr. Galloway: This kind of approach using magnetic energy and magnetic fields is something that’s very familiar to all of us. We’ve all heard of MRI, or magnetic resonance imaging, where we put a patient into an imaging system where the magnetic field allows the doctors to create an image of the structure of the body. This uses a slightly different kind of magnetic principle, but broadly speaking the energies are of the same family.
Does it hurt?
Dr. Galloway: No. It doesn’t hurt at all, and that’s unusual for medical treatments. When we do good things for patients in medicine, we tend to do it by putting a needle in the arm or giving a nasty tasting medicine. This is rather unlike that because it doesn’t hurt, and it’s totally painless. You can do all of this with your clothes on.
What kind of success rate have you had?
Dr. Galloway: We’ve been very encouraged by the success rates. We’ve been looking at a multi-center study using a number of centers throughout North America. As we look at this in a broad group of patients, we find at least four out of five patients gain benefit from this kind of treatment. A third of patients will be dry after treatment who previously had been using two or three pads a day for protection in the month before treatment.
Does this replace medication or surgery?
Dr. Galloway: I think it’s going to replace surgery for some patients. We hope that if we can treat patient before the muscles become too very weak that we’ll be able to avoid surgery for a lot of patients.
How does it make you feel seeing something like this come along with these results?
Dr. Galloway: I’m a surgeon, and I spend my time treating patients with surgery. There’s no such thing as a brave surgeon. There are only brave patients. I think most of us feel that the time for surgery is when conservative treatments have been tried and failed. Often times patients perceive treatment to be unpleasant or unattractive or possibly that surgical treatment is not going to work. They know friends who have had an operation, and it just hasn’t helped. There’s a reluctance to seek help with incontinence until it’s very late in the day. These sorts of conservative treatments that strengthen muscle work very, very well if the muscles are not already extremely weak. So as we begin to approach the patients who need our help, the patients who are going to do best are those who have mild to moderate leakage and who have not been having leakage for 10 years but have been having leakage for just one or two years. These patients we can really help enormously.
Have you ran into any skepticism?
Dr. Galloway: Of course. This sort of treatment has been the source of a certain amount of humor and jocularity, whether with my own colleagues here or in meetings. However, we ask those who are interested in this to feel what it feels like to sit on the chair. This is something that doesn’t make sense when we talk about it. It sounds like smoke and mirrors, but as soon as you feel the effect of the change in magnetic field on your own muscles, you’re in no doubt at all that this is making your muscles work. Because we can make the muscles work very fast, as fast as 20 or 30 contractions every second, we can do more exercises for these muscles in a very short space of time than was ever believed possible.
Can you sum up what a serious problem stress incontinence is and maybe some of the psychology involved?
Dr. Galloway: Urinary incontinence is a problem that is very, very prevalent in North America. There are more patients in North America who suffer incontinence than everybody with diabetes and cancer added together. This is a very important problem. It’s a problem that has a very large cost in terms of health and social costs. At a personal level, this is something that creates social isolation. Incontinence is the second most common reason that our older family members leave their homes and go into residential care. As time goes on it is going to be more and more important that we have alternative treatments that allow us to avoid going down that inevitable path. This form of therapy truly seems to offer a dignified solution to what has always been a very undignified problem.
Ivanhoe Broadcast News Interview Transcript with Dr. Niall Galloway, Associate Professor of Surgery and Urology
Emory University School of Medicine, Atlanta, Georgia @1999