MIL-therapy / Method of treatment / 7.11. Urology.
MIL-therapy is very effective for treating patients in post-operative period, after reconstructive-restorative surgeries on the ureter, after surgeries for urethric and cystic-vaginal fistulas, plastic surgeries for urine incontinence. Irradiation is applied to postoperative sutures in several zones (for 2 min on each zone) with frequency 80 Hz, LED radiation power 50 mWt daily (6-8 procedures). The course is repeated in 4-5 days.
Chronic cystitis and the infiltrate in the pelvis
MIL-therapy is indicated in the complex treatment of patients with chronic cystitis and infiltrate in the pelvis to prepare them for reconstructive-restorative surgeries at distal parts of the ureter. The terminal is applied in a contact stable way (Fig. 28) on the supra pubic zone (zone 5) and on the iliac region (zones 4) for 2 min on each zone. Impulse frequency is 80 Hz, LED radiation power is 80 mWt. The course of treatment consists of 10-12 daily procedures.
MIL-therapy is indicated in pre-operative period. The terminal is applied (Fig. 29) parasternally (zones 2) at the 2nd intercostal space. Impulse frequency is 5 Hz, LED radiation power is 40 mWt, exposure is 2 min on one zone. Afterwards, the irradiation is done posteriorly to the stone projection (zone 5) for 2 min with frequency 5 Hz, for 2 min with frequency 150 Hz and for 2 min with frequency 5000 Hz. The terminal slowly moves 12-15 cm. down. In 4-6 hours MIL-irradiation is applied to the inguinal vascular bundles (zones 6) with frequency 5 Hz, LED radiation power 90 mWt during 5 min on each side. Then the irradiation is applied to feet surfaces; the terminals are slowly moved from zone 1 to zone 2 (only in this direction) for several times during 1 min (frequency 10 Hz, LED radiation power 100 mWt).
The course of treatment (combined with medicamentous therapy) lasts for 5-7 days with daily MIL-sessions. In many cases MIL-therapy applied under this scheme together with drinking much liquids and medicamentous therapy (spasmolitics, analgetics, etc.) facilitates stone excretion thus, leading to the cancellation of the planned surgery. After the stone excretion is completed (or in a postoperative period) MIL-therapy is performed daily during 5-7 days 1-2 times a day. Irradiation is applied to the area of affected kidney (zone 5) and on the inguinal vascular bundles (zones 6). IR LILR impulse frequency is 600 Hz, LED radiation power is 90 mWt, exposure on each zone is 2 min.
Traumatic ureter fistulas
At the site of ureter implantation after plastic surgeries at the lower third of the ureter one can infrequently see a secondary stenosis: inflammation at the anastomosis and in the adjacent tissues leads to a long lasting anastomositis caused by a club-shaped edema and postoperative trauma.
Fig. 30. Zones of MIL-irradiation in treating urolithiasis
In patients survived plastic surgeries at the distal parts of the ureters, especially in case of indirect plastics with the bladder wall (flap-type surgeries by Boari, Demel, Lopatkin) the syndrome of so-called irritated bladder is formed . Dysuria gets more pronounced because of long-staying urethral and ureter drainage tubes used in the postoperative period. The picture of bullous edema develops in some places due to the augmentation of inflammatory changes around the anastomosis; at the site of implantation of the ureter into the bladder the mucous becomes folded. Complex treatment with the application of MIL-therapy improves results of surgical treatment in such patients: signs of anastomositis are reduces by 75%.
MIL-therapy is prescribed on the first postoperative day with 7-8 daily sessions. The terminal is consecutively put on two zones at the anastomosis projection, after that - on the projection of the inguinal vascular bundle (Fig. 29, zones 6). Exposure is 2 min on each zone, impulse frequency is 50 Hz during first three procedures, after that - 80 Hz; LED radiation power is 50 mWt.
Cystitis (catarrhal, ulcerative, ulcerative-fibrinotic, granular chronic)
Signs of the inflammation in bladder mucous are accompanied by the signs of local and generalized hypoxia which is revealed during endoscopic and angioscopic investigations. Microcirculatory impairments of spastic or spastic-atonic type are revealed in all patients. Number of microvessels is decreased in a half of patients.
MIL-therapy is performed daily (7-8 procedures for the course). The terminal is subcunateously applied on the bladder (zone 4) (Fig. 30), then on the barbate process LV (zone 3): exposure is 2 min, frequency is 50 Hz, LED radiation power is 70 mWt. After that the thymus projection (zone 2) and the left subclavicular vascular bundle (zone 1) are irradiated for 2 min. each . Impulse frequency is 80 Hz, LED radiation power is 50 mWt. In case of necessity the course is repeated in 2 weeks.
Fig. 31. Zones of MIL-irradiation in treating cystitis (catarrhal, ulcerative, ulcerative-fibrinotic, granular chronic)
Reduction of the conjunctive indicator, significant improvement of microcirculation are seen after 2-3 MIL-sessions in 82% of patients on the average with further progress by the end of the treatment ( by the 8-10th session). A comparative analysis of MIL-therapy effectiveness and intravenous injections with reologically active preparations has shown quite obvious advantages of MIL-therapy because microcirculation improvement under MIL-irradiation was more prolonged.
MIL-therapy is combined with medicamentous treatment and gland massage ( MIL-therapy preceeds the massage). The terminal is put (Fig. 31) on the perineum with moderate compression of soft tissues (before the anus) and above the pubis bone (zone 1), exposure for 2 min on each zone. After that the inguinal vascular bundles (zones 3) are irradiated for 2 min and 1-2 painful zones in the sacrum area (zones 2) defined by a physician on palpation are irradiated too (for 2 min). Impulse frequency is 80 Hz, LED radiation power is 50 mWt. 8-10 daily sessions.
Totally, MIL-therapy is performed within 2-3 courses with two- week breaks in-between. The treatment may be repeated in 6 months, in case of necessity.
Fig. 32. Zones of MIL-irradiation in treating prostatitis