**5.2 Effect on detrusor overactivity**

Detrusor overactivity is a common cause of urge incontinence in elderly and young patients. It occurs when the detrusor muscle contracts intermittently for no apparent reason when the bladder is partially or almost completely filled. Detrusor overactivity can be idiopathic or due to dysfunction of the detrusor center of the frontal lobe (generally due to age-related changes, dementia, or stroke) or lower urinary tract obstruction. Urinary muscle overactivity with contractile force disorder is a variant of urgency urinary incontinence, characterized by urinary urgency, pollakiuria, decreased urinary retention, urinary retention, bladder pillar formation, and post-micturition residual urine volume of over 50 mL. In a study comparing magnetic therapy with the placebo group for idiopathic detrusor hyperactivity, the magnetic therapy group significantly reduced the number of micturitions per day compared to the placebo group. It was also confirmed that the number of urination and QOL per day improved although the sample size was not sufficient [19].

In a randomized controlled trial of 32 men and women comparing the effects of magnetic and electrical stimulation, a significant increase in bladder capacity was found in the magnetic stimulation group [20].

#### **5.3 Effect on neurogenic overactive bladder**

Neurogenic bladder is a lower urinary tract dysfunction caused by a neurological disorder, and the diagnosis is based on urodynamic testing. When the upper part of the pontine detrusor center existing in the brain stem is damaged, neurogenic detrusor overactivity causes the bladder to contract involuntarily against the intention of the person occurs, resulting in urge incontinence and pollakiuria. In a study comparing the effects of pulsed electromagnetic field therapy (PEMFT) and transcutaneous electrical nerve stimulation (TENS) on neuropathic overactive bladder dysfunction in patients with spinal cord injury (SCI), 50 male and 30 female patients (average age of 40 years) with secondary neuropathic overactive bladder due to spinal cord injury were recruited. Urinary tract dynamics (UDS) were performed before and after treatment. 40 patients received TENS (10 Hz, 700 second pulse) 3 times/week, for a total of 20 times and the remaining 40 patients received PEMFT (15 Hz, 50% intensity 5) 3 times/week, for a total of 20 times. As a result, the maximum cystometric capacity, volume at first uninhibited detrusor contraction, and maximum urinary flow rate were significantly increased in the PEMFT group, indicating that PEMFT is superior to TENS in terms of therapeutic effect [21].

*Therapeutic Effect of Magnetic Stimulation Therapy on Pelvic Floor Muscle Dysfunction DOI: http://dx.doi.org/10.5772/intechopen.99728*

#### **5.4 Effect on bedwetting**

Nocturnal enuresis is usually the involuntary urination during sleep after the age at which bladder control begins. According to the American Psychiatric Association's DSM-IV, primary nocturnal enuresis (PNE) was described as "children 5 years and older who repeatedly urinate in bed and clothing twice a week for at least 3 consecutive months, not resulting from side effects and medical conditions of drugs. " Nocturnal urine in children and adults causes mental stress and sometimes causes complications such as urinary tract infections. A study evaluating the potential clinical and urodynamic effects of functional magnetic stimulation (FMS) in the treatment of girls with primary nocturnal enuresis (PNE) compared to placebo reported the effects of magnetic therapy. 20 PNE girls (average age of 10.8 years) were given a magnetic stimulator for 2 months day and night, the number of episodes of nocturnal urine decreased from 3.1 to 1.3 times a week in the magnetic therapy group before and after treatment. In addition, the bladder volume at the strong desire to void increased significantly compared with the placebo group [22].

Monosymptomatic nocturnal enuresis (MNE) refers to patients with nocturnal enuresis without other lower urinary tract symptoms such as daytime urinary incontinence and urgency. In a study that randomly assigned 44 patients with MNE to receive 10 sets of repetitive sacral root magnetic stimulation (rSMS), the treatment group significantly improved the mean nocturnal urine per week compared to the placebo group. The effect was maintained even 1 month after the treatment. The treatment group also showed improvement in visual analog scale (VAS) and quality of life [23].

### **5.5 Effect on chronic pelvic pain syndrome**

Chronic pelvic pain syndrome includes inflammation of the prostate gland, pain from the lower abdomen to the lower body, discomfort around the pelvic body, urinary symptoms such as close urine and feeling of residual urine, discomfort during ejaculation, and erectile dysfunction. It is a disease reminding of sexual dysfunction. Although the exact causes have not been clarified yet, blood flow disorders and autoimmune reactions around the prostate gland, urine reflux into the prostate gland due to dysuria, sensory nerve abnormalities in the pelvis and lower body, adrenal gland hormones and abnormalities in sex hormones are believed to be the causes. It is often seen in relatively young people (late teens to 40s), and the symptoms worsen when the perineal area is compressed by a long sitting posture (desk work, driving a car, bicycle, motorcycle, etc.).

In addition, psychological stress, fatigue, smoking, excessive drinking, and poor circulation are also factors that worsen the symptoms. It is characterized by the absence of typical symptoms but various symptoms from the lower abdomen to the lower body start to appear. Pain may be felt not only in the perineum near the prostate, but also in areas not related to the prostate, such as the lower back, urethra, groin, thighs, and lower abdomen. In addition, it may be accompanied by urinary symptoms such as close urine, feeling of residual urine, weak urine momentum, pain in the urethra when urinating, and sexual dysfunction such as discomfort during ejaculation and erectile disorder.

A randomized, placebo-controlled, double-blind study of 60 men with refractory chronic pelvic pain syndrome evaluated improvement in the Chronic Prostatic Inflammatory Symptom Index (NIH-CPSI) of the National Institutes of Health. The QOL score was significantly improved 12 weeks after treatment compared to the placebo group. In addition, patients with persistent symptoms of 1 year or less were more effective than patients with long-lasting symptoms [24].

On the other hand, there are also studies in which randomized, double-blind, placebo-controlled treatment was used for chronic pelvic pain in women. In this study, 32 patients with chronic pelvic pain were treated with active magnets (500G) or placebo magnets 24 hours a day at trigger points in the abdomen. After 1 month of treatment, McGill Pain Questionnaire, Pain Disability Index and Clinical Global Impressions Scale were evaluated. As a result, the Pain Disability Index, Clinical Global Impressions-Severity, and Clinical Global Impressions-Improvement were significantly lower in the treatment group than in the placebo group, demonstrating the therapeutic effect of magnetic therapy [25].

#### **5.6 Effect on fecal incontinence**

Fecal incontinence is defined as an involuntary leak of liquid or solid stool that poses a social or hygienic problem. Fecal incontinence is not life-threatening, but it is an intolerable symptom for patients and significantly impairs their quality of life. The prevalence of fecal incontinence over the age of 65 in Japan is 8.7% for men and 6.6% for women. In the elderly, the onset of fecal incontinence often triggers admission to a facility, and it is thought that even for home care recipients, the most worrying thing about caregivers is receiving excretory care. Fecal incontinence is classified into leaky fecal incontinence, in which stool leaks without being noticed, urgent fecal incontinence, in which stool leaks without being able to endure the toilet, and mixed fecal incontinence, which is a mixture of both. It is roughly divided into. Leaky fecal incontinence is more likely to occur when the internal anal sphincter is impaired, and urgent fecal incontinence is more likely to occur when the external anal sphincter is impaired. The internal anal sphincter muscles often weaken with age, and the external anal sphincter muscles are often injured by labor or surgery for rectal cancer.

Surgical treatments for fecal incontinence include sacral stimulation therapy, anal sphincter plasty, and stoma construction. From the viewpoint of evidence and invasiveness, it is desirable to try non-invasive therapies first. Non-invasive therapies include diet / lifestyle / defecation habit guidance, drug therapy, pelvic floor muscle training, biofeedback therapy, butt plugs, and retrograde intestinal lavage (irrigation defecation). The objectives are fecal solidification, increased contractility of the pelvic floor muscles, including the external anal sphincter, normalization of rectal sensation, and regular emptiness of the rectum and colon.

In a study reporting the effects of magnetic therapy on fecal incontinence, 10 patients with fecal incontinence with an average age of 57 years received perineal magnetic stimulation (10 Hz and 50 Hz) twice weekly for 5 weeks. Both 10 Hz and 50 Hz stimulation significantly increased anal pressure compared to baseline rest. After treatment, anal pressure increased significantly and the score for fecal incontinence improved significantly [26].

## **6. Application to men's health**

Erectile dysfunction (ED), one of the male sexual dysfunctions, is defined as persistent or recurrent erections that are insufficient or unsustainable for satisfactory sexual activity. ED is the second most common sexual problem in men after premature ejaculation, and epidemiological studies indicate that it affects 30 million people in the United States. ED has a strong negative impact on self-esteem and self-confidence, can reduce the quality of life for men and their partners, and can affect all aspects of life. The pathophysiology of ED includes angiogenic, neurogenic, anatomical, hormonal, drug-induced, and / or psychogenic causes.

#### *Therapeutic Effect of Magnetic Stimulation Therapy on Pelvic Floor Muscle Dysfunction DOI: http://dx.doi.org/10.5772/intechopen.99728*

Risk factors for ED include aging, diabetes, obesity and lack of exercise, cardiovascular disease and hypertension, smoking, chronic kidney disease, lower urinary tract symptoms, neurological disorders, depressive symptoms, drugs, sleep apnea syndrome, etc. As a treatment, oral preparations such as sildenafil and intraspinal injection are used. However, patients often change treatment methods due to lack of therapeutic effects and the high costs. Therefore, a therapeutic approach that emphasizes long-term satisfaction is needed.

The magnetic field induces an alternating current in the electrolyte in the body, which affects the water content of cells, mitochondrial function, nutrition, oxygen, amino acid uptake, energy production, etc. Appropriate magnetic fields can increase the uptake of oxygen by cells, promote blood circulation, and restore dysfunction. In a canine study, magnetic stimulation of the corpus cavernosum nerve increased intracavitary pressure, resulting in a complete penis erection after an incubation period of approximately 8 seconds. Upon discontinuation of stimulation, erection and intracavitary pressure returned to baseline after an average of 14 seconds [27]. In a study of 32 neuropathic ED patients and 20 healthy volunteers, a magnetic coil was placed on the dorsal side of the penis near the symphysis pubis, with 40% strength, 20 Hz frequency, and 50 seconds of magnetism. The stimulation was performed, and 50 seconds later, the magnetic stimulation was stopped. As a result, the magnetic therapy group was able to induce penile stiffness non-invasively without side effects [28]. A double-blind, placebo-controlled trial evaluating the effectiveness of impulse magnetic-field therapy for psychogenic erectile dysfunction or orgasmic disorders has also been reported [29]. Twenty men between the ages of 30 and 60 who suffered from ED and orgasm dysfunction were treated with Impulse magnetic-field therapy for 3 weeks, and the treatment group showed improved erection intensity, duration, well-being and sexual activity as compared to the placebo group [29]. No side effects from treatment were reported.

The data above supports the effectiveness of magnetic therapy for various types of ED, drawing more and more attention to magnetic therapy in the men's health community.
