The Ins and Outs of Electrodes- FAQ | Pelvic Floor Exercise
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The Ins and Outs of Electrodes- FAQ

Posted in Product Reviews on the 21st July 2017

How do I know if an electrode is compatible with my machine?

All of the electrodes we sell on Pelvic Floor Exercise are compatable with all of the machines we sell (stimulation and EMG)
Electrodes couple to a machines leads via 'male' and 'female' connections. The male connection is a pin and the female connection is recessed. The male fits into the female ( wonder where that came from?)
Most electrodes have pins which fit into the lead which in turn connects to the machine.

What is the difference between the electrodes?

PFLEX 20mm / 25mm VAGINAL ELECTRODE :

Points of difference:

  •  comes in two sizes 20mm and 25 mm diameter so choice is dependent on hiatal or vaginal size
  • electrode plates are circumferential which can be advantageous for maximising potential contact esp if not sure of innervation or whether fully intact levators

PFLEX Lifecare PR 18A : 

Points of difference:

  • Similar style to the popular Veriprobe which is no longer available.
  • A good all round electrode that has a flange on the base to assist insertion and to help ensure electrode plates are in correct orientation with the deep pelvic floor muscle layer.

PFLEX Lifecare PR 02A

Points of difference:

  • Rounded on the end and narrower at the flange, this electrode can be very helpful particularly for treating pelvic pain as following the initial insertion it is usually more comfortable and more easily retained within the vagina than one with a wider neck.
  • The round flange doesn't always allow you to know exactly which direction the electrode plates are facing but does allow for adjustment via turning if you are not feeling stim ulation sensation where you want it.

PERIFORM+ :

Points of difference:

  • Has been designed to fit the shape of the vagina better, which is especially good for women with larger hiatus, ensuring better contact.
  • It is the sister product to the Pelvic Floor Educator, and can double as one as it comes with the same indicator stick . This allows you to see if you are doing a contraction - the stick will move downwards ( towards the tailbone) when activating the pelvic floor correctly and can be used whether attached to a stimulation machine or not.
  • The eletrodes on the PERIFORM+ make it slightly wider than the Pelvic Floor Educator so can be used as an educator for women with a larger levator hiatus (LH) even if it is not being to be used for stimulation or EMG.

LIFECARE PLUS GOLD-PLATED PR-02A

Points of difference:

  • electrode plates contain base metals including a small amount of nickel. For users with a nickel allergy , this gold-plated electrode is ideal as it will not cause an allergic reation 
  • comes with an indoicator stick similar to the Periform+ which acts as a biofeedback tool to assit with seeing/feeling the correct action and can be used separately as a pelvioc floor educator.

ANUFORM ANAL ELECTRODE

Points of difference:

  • comfortable easy to insert anal electrode that automatically sits in the correct position within the anal canal
  • can be used vaginally in very small women (obviously not if also being used anally)

PFLEX ANAL PROBE 10mm PR-06

Points of difference:

  • small width with 2 circumferential electrode plates to ensure contact
  • narrowed neck to fit smaller anal verge

PFLEX ANAL PROBE 12mm WITH COLLAR PR-13

Points of difference:

  • longer insertable length
  • control depth of insertion and repeat insertion depth with collar
  • 2 circumferential electrode plates to ensure contact 

For pelvic floor electrical stimulation, which lubricant should I use?

Water-based lubricant is the best for use with vaginal and anal electrodes for assisting insertion. Only use enough to help insertion - you do not need it for contact as the electrode plates are in direct contact with mucosal tissue , unlike external electrodes which need to overcome the impedance of the skin in order to create contact..

Which external electrodes should be used?

This depends on what area of the body you are treating and what you intend to do.
The larger the electrode, the larger the surface area for stimulation delivery. To get the required depth, electrodes should be no closer than a pad size.
For example, a 50mm electrode needs to be 50 mm away from its nearest neighbour. 

Commonly used sizes :

  • 30mm round diameter are ideal for perianal use
  • 40 x 40mm square and 50 x 50mm square are the most common sizes.
    These are ideal for TTNS - transcutaneuos  tibial nerve stimulation- and sacral nerve stimulation
    (50 x 50mm are supplied with the Neurotrac TENS)
  • 40 x 90mm  50 x90mm  and 50 x 100mm can all be used with Obstetric TENS for pain relief in labour and for persistent pelvic pain such as endometriosis - the electrodes can be used around the thoracic spine and the sacral area or for pelvic pain even over the abdomen. The 50 x 90mm are the standard size supplied with the Obstetric TENS. These can also be used with the TENS machine 
  • Size chosen will depend on patient size and intended use.

Do you sell electrodes that will fit machines that are not on your website?

All of our electrodes are female so as long as your leads are male they will fit. This applies to both internal and external adhesive electrodes.
However you need to check that the machine you have is able to do the job you want it to. 
For more on electrical stimulation  and TENS machines read Fiona's resource page

When using the vaginal electrode do you also use a surface electrode/s & if so where is the best placement for them?

You only need a surface (earthing) electrode if using EMG. In that case you place it on a bony prominence . The ASIS ( the bony bit at the front of the hip, just below the waist)  is usually used when perfomriong EMG in the pelvic region. This is purely to reduce extraneous pick up of signals or artifacts.
For electrical stimulation you do not need an earthing electrode.

If I am just using surface electrodes where are they placed and how many do you use?

This depends on purpose of doing it and whether you are doing electrical stimulation or TENS. The most common uses of  external electrodes when addressing pelvic health issues are:

  1. When you are doing sacral, tibial TENS for urinary or faecal urgency or pain
  2. When doing any placement for pain -sacral, tibial, suprapubic, thoracic
  3. For EMG biofeedback especially for EAS (external anal sphincter) 
  4. When internal (vaginal/rectal) electrode use is contra-indicated or not appropriate.
    For eg:
  •  patient is too young
  •  never been sexually active
  •  not keen to try internal mode
  •  poor tissue compliance
  •  poor dexterity that may make using probe difficult.

Whilst much of the research indicates that direct stimulation gets better results, this will only be so if the user is compliant and comfortable using it.
Externally placed electrodes deliver current via indirect routes so to speak but along similar pathways.

It is generally accepted that you use 2 electrode pads via one channel for tibial stimulation and can use either one ( 2 electrode pads ) or two ( 4 electrode pads ) channels over the sacrum. 
Some people also use pads suprapubically which is not directly over any of the pathways. There is less research evidence for suprapubic application, however it has a calming sensory effect for some people and easier to apply at home.

 

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