TensCare itouch sure Instructions For Use Manual

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INSTRUCTIONS FOR USE
READ CAREFULLY BEFORE USE
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QUICKSTART GUIDE
Connect the unit with the
vaginal probe
Insert the vaginal probe
Press and hold the ON button
to switch the device on
Regulate the output intensity with
the buttons and
Press and hold the OFF button
to switch the device off
ON
Button P
UP
DOWN
OFF
Select the programme by
pressing the button P
1
2
3 4 5
6
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Dear Customer,
Thank you for choosing itouch sure. TensCare stands for high-quality, thoroughly tested products for the applications in the areas of gentle electrotherapy, muscle toning, continence management and pain relief during labour.
Please read these instructions for use carefully and keep them for later use and observe the information they contain.
Best regards, Your TensCare Team
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Contents
1. INTRODUCTION ................................................................................................. 6
2. INTENDED USE .................................................................................................. 6
3. ITOUCH SURE FEATURES ................................................................................ 7
4. PELVIC FLOOR EXERCISES ............................................................................. 7
4.1. PELVIC FLOOR MUSCLES .......................................................................... 7
4.2. PERFORMING PELVIC FLOOR EXERCISES ............................................. 9
5. TYPES OF INCONTINENCE ............................................................................. 10
6. HOW ‘EMS’ WORKS ......................................................................................... 10
7. CONTRAINDICATIONS, WARNINGS & CAUTIONS ........................................ 11
8. INFORMATION ABOUT THE PROGRAMME SETTINGS ................................ 14
9. PROGRAMMES ................................................................................................ 15
9.1. PROGRAMME SETTINGS ......................................................................... 15
9.2. PRESET PROGRAMMES .......................................................................... 15
10. CONTENT ......................................................................................................... 16
11. UNIT INFORMATION ........................................................................................ 17
11.1. CONTROLS & DISPLAY ......................................................................... 17
11.2. OPERATING INSTRUCTIONS ................................................................ 18
12. SETTING UP AND USING THE ITOUCH SURE ............................................... 20
12.1. INSTALLATION OF BATTERIES ............................................................. 20
12.2. CONNECTING LEAD WIRE .................................................................... 21
12.3. PREPARING FOR SESSION .................................................................. 21
12.4. TRAINING SESSION ............................................................................... 22
12.5. AFTER YOUR TRAINING SESSION ....................................................... 24
13. ANAL PROBE .................................................................................................... 24
13.1. CONDITIONS THAT MAY BE TREATED ................................................ 24
13.2. HOW TO INSERT THE ANAL PROBE .................................................... 25
14. CLEANING ........................................................................................................ 25
15. EMC ................................................................................................................... 26
16. DISPOSAL OF WASTE ELECTRICAL AND ELECTRONIC PRODUCTS ........ 26
17. ACCESSORIES ................................................................................................. 26
18. WARRANTY ...................................................................................................... 27
19. TROUBLESHOOTING ....................................................................................... 29
20. GENERAL SPECIFICATION ............................................................................. 31
NOTES ..................................................................................................................... 33
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SYMBOLS USED
Attention! Please follow the instructions in the user’s instructions for use.
TYPE BF EQUIPMENT: Equipment providing a degree of protection against electric shock, with isolated applied part. Indicates that this device has conductive contact with the end user.
This symbol on the unit means “Refer to instructions for use”.
Temperature Limitation: indicates the temperature limits to which the medical device can be safely exposed.
Lot Number: indicates the manufacturer’s batch code so that the batch or lot can
be identified.
Humidity Limitation: indicates the humidity limits to which the medical device can be safely exposed.
Serial Number: indicates the manufacturer’s serial number so that a specific
medical device can be identified.
Do not dispose in household waste.
Catalogue Number: indicates the manufacturer’s catalogue number so that the device can be identified.
This medical device is not water resistant and should be protected from liquids.
Atmospheric Pressure: indicates the atmospheric limits to which the medical device can be safely exposed.
Date of Manufacture: indicates the date which the medical device was manufactured. This is included within the serial number found on the device
(usually in the battery compartment), either as “E/Year/Number” (YY/123456) or
“E/Month/Year/Number” (MM/YY/123456).
This medical device is indicated for home use.
The first number 2: Protected against access to hazardous parts with a finger, and the jointed test finger of 12 mm ø, 80 mm length, shall have adequate clearance from hazardous parts, and protected against solid foreign objects of 12.5 mm ø and greater.
The second number 2: Protected against vertically falling water drops when
enclosure is tilted up to 15˚. Vertically falling drops shall have no harmful effects
when the enclosure is tilted at any angle up to 15˚ on either side of the vertical.
LOT
S/N
REF
IP22
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1. INTRODUCTION
Device Description & Principles of Design
Bladder leakage and incontinence are common problems for both women and men, affecting their long-term health. Exercising the pelvic floor muscles is recognised as the way of preventing and treating symptoms of incontinence and pelvic floor weakness.
The itouch sure is a powered muscle stimulator used for strengthening the pelvic floor muscles.
It sends a gentle stimulation (similar to your natural nerve impulses) direct to your pelvic floor muscles through a vaginal probe with stainless steel electrodes. These signals make your pelvic floor muscles contract. If you have forgotten how to contract them, are having trouble getting muscle response, or simply want to bring back the condition of your pelvic floor muscles, the itouch sure can work them for you to build up their strength and help you to develop your own muscle control. It perfectly complements pelvic floor exercises. The itouch sure is very easy to use, with four clearly labelled preset training programmes and a simple push button control.
The itouch sure provides relief from conditions such as:
Urinary and faecal incontinence: including stress, urge and mixed types as well as post prostatectomy urinary incontinence in men. Additionally, it may help improve
sexual intimacy by toning the pelvic floor muscles.
Treatment of erectile dysfunction in men* and improvement of pelvic
strength (* requires an anal probe).
2. INTENDED USE
Itouch sure is a medical
device designed to be used in
the home healthcare environment to treat symptoms of urinary and/or faecal incontinence and is suitable for use by all who can control the device and understand the instructions.
Do not use the device for any purpose other than this intended use.
Warning: Not suitable for use
in children without medical
supervision.
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3. ITOUCH SURE FEATURES
Single Channel
Single channel unit provides relief from symptoms of all types of incontinence via a tampon-shaped probe.
Comfortable Stimulation
Gentle stimulation in small steps of intensity, 0.5 mA per step.
4 Preset Programmes
Clinically tested programmes for all types of incontinence including stress, urge, mixed and a tone aftercare programme.
Treatment Timer
Unit defaults to 20 minutes’ treatment to
ensure the pelvic floor muscles are not overworked. The user can manually reset this (20,30,45,60 or 90 mins).
Open Circuit Detection
Automatically resets the strength to
zero and flashes ‘LEADS’ if the
connection comes loose.
Keypad Lock
Enables the user to manually lock the controls to prevent any accidental changes in settings.
Large Backlit Screen
Clearly shows the operation of the unit and the programme and intensity currently being used.
Memory
Features 3 functions: programme retention (automatically starts in the last programme used), number of uses and time of usage.
4. PELVIC FLOOR EXERCISES
4.1. PELVIC FLOOR
MUSCLES
The “FLOOR” of your pelvis is made up
of layers of muscles that support the bowel, bladder, urethra and uterus. These muscles are like a hammock, or the bottom and sides of a bowl, in shape. They run from the pubic bone in the front to the end of the spinal column (or tail bone) in the back.
The pelvic floor muscles:
Assist in supporting the abdominal
and pelvic organs.
Work with the abdominal and back
muscles to stabilise and support the spine.
In women, also
o provide support for the baby
during pregnancy and
o assist in the birthing process
Pelvic floor muscles are also important for sexual function in both men and women:
In men, it is important for erectile
function and ejaculation.
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In women, voluntary contractions (squeezing) of the pelvic floor contribute to sexual sensation and arousal.
However pelvic floor muscles may become weak. If your pelvic floor muscles become stretched or weakened, your pelvic organs may no longer be fully supported and you may lose control of your bladder or bowel movements.
For some women, the pelvic floor muscles can also become too tight. This condition is less common, but it can lead to pelvic pain and make it difficult for you to empty your bladder or bowel completely.
Common signs that can indicate a pelvic floor problem include:
Accidentally leaking urine when you exercise, laugh, cough or sneeze
Needing to get to the toilet in a hurry or not making it there in time
Constantly needing to go to the toilet
Finding it difficult to empty the
bladder or bowel
Accidentally losing control of the bladder or bowel
Accidentally passing wind
Pain in your pelvic area
Painful sex, or
A prolapse
In women, this may be felt as a bulge in the vagina or a feeling of heaviness, discomfort, pulling, dragging or dropping. This occurs when one or more of the pelvic organs (bladder, bowel or uterus) become displaced and
sag down into the vagina. It is very common in the United Kingdom and occurs in about 40% of women. Symptoms tend to become exacerbated towards the end of each day and if left untreated, they will generally worsen over time.
In men, this may be felt as a bulge in the rectum or a feeling of needing to use the bowel but not actually needing to go.
Like other muscles in your body, the pelvic floor can be strengthened with regular exercise. Building pelvic floor strength enables the muscles to better support your pelvic organs, improves your bladder and bowel control and can stop accidental urine, faeces or wind leakage.
It can also reduce your risk of prolapse, improve your recovery from childbirth and gynaecological surgery, and increase your sexual pleasure. A continence therapist can help you learn how to exercise your pelvic floor.
Doing just a few pelvic floor exercises every day will help to treat bladder weakness or prolapse symptoms, and will help to prevent problems later on.
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4.2. PERFORMING PELVIC
FLOOR EXERCISES
It is recommended to make Pelvic Floor Exercises (sometimes called Kegel Exercises) part of your daily life.
1) Kegel exercises can be done at any time and are very discreet so you can do them almost anywhere; lying in bed, sitting at the computer or waiting for a bus. It is a good idea to try and develop a routine which you can repeat each day.
2) First, it is important to find your pelvic floor muscles and feel them working. So here are a couple of techniques which might help: Try inserting one or two clean fingers into your vagina and then squeezing the surrounding muscles, lifting up and towards your belly button – a squeezing and lifting sensation. Another way is to try and stop the flow of urine during urination. If you are successful, then you know you are exercising the correct muscles.
Note: These techniques are
just to help you confirm that you are using the correct muscles. It is important to have an empty bladder before starting the exercises.
3) Try to remember the lifting and
squeezing sensation and when you are ready try to recreate it just using the muscles you identified earlier; don't tense the muscles in your legs, stomach or buttocks and remember to breathe normally.
4) Aim to hold each squeeze or
'contraction' for three to five seconds, then release and relax.
You should feel a ‘letting go’ of the
muscles. Rest for five seconds and then repeat.
5) Try and do about ten squeezes in this way.
6) Repeat the whole process three or four times a day.
7) Over a period of time try to increase the muscle contractions up to about ten seconds, but remember to rest in between each squeeze for longer periods.
Note: It is important to aim for
quality contractions, not quantity, so a few good hard squeezes are better than a series of weak ones.
Do not worry if you find holding for 3 seconds difficult at first. Just squeeze for as long as you feel comfortable to do so. The more exercise you do, the stronger the muscles will become and the longer you will be able to squeeze.
8) Using your itouch sure pelvic floor
stimulator in conjunction with Kegel exercises will give you a better understanding of how they work and how to get the greatest benefit from them.
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5. TYPES OF INCONTINENCE
There are three types of incontinence: Stress, Urge, and Mixed.
Stress Incontinence If you leak urine when you cough,
sneeze, laugh, strain or make sudden movements, this is called Stress Incontinence.
It is particularly common in women who have had a natural childbirth and occurs when the bladder neck and the other mechanisms that act to hold urine in the bladder are not working properly. The most common cause is a weak pelvic floor.
Urge Incontinence Describes an overactive bladder. A
person may experience a strong and sudden urge to go to the toilet but are not always able to hold on, or must go so frequently that it becomes inconvenient.
Mixed Incontinence Is a combination of both Stress and
Urge Incontinence.
6. HOW ‘EMS’ WORKS
E.M.S. stands for Electrical Muscle Stimulation and has successfully been used in medical rehabilitation and training in competitive sports. EMS produces intensive and effective muscular contraction.
In rehabilitation, EMS is a well­established method for treatment of a broad field of musculoskeletal diagnoses as well as pelvic floor weakness. Electrical stimulation of an intact peripheral nervous system may create motor responses in patients with impaired or lost ability for voluntary muscle activity.
EMS is a complement to other physical therapy and should always be combined with active training such as Kegel exercises (see section 4.2.).
Advantages of EMS
Use of EMS may lead to faster progress
in the patient’s treatment programme.
The method is simple and appropriate for treatment in the clinical setting as well as for self-treatment at home.
How EMS Works
Electrical Muscle Stimulators can play a vital role in educating women and men about their pelvic floor and the sensation they should feel when doing pelvic floor exercises. Electrical Pelvic Floor Exercisers (PFE) offer a non­invasive method of producing contraction of muscles via a gentle stimulation to the pelvic floor through a discreet probe or electrode pads when
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they are placed close to the nerve that controls the pelvic floor muscles. This current then passes into the nerve fibres controlling that part of the muscle stimulating it to contract. So, electrical stimulation (EMS) artificially activates a muscle for you enabling you to develop your own muscle control. These contractions exercise the muscles and, as with any kind of exercise if performed regularly, build strength and tone.
In urge incontinence, pelvic floor exercisers work in a slightly different way. The electrical stimulation is designed to soothe your bladder muscles rather than exercise your pelvic floor. Itouch sure uses a gentler, low frequency setting which promotes release of endorphins and reduces involuntary contractions of the bladder (detrusor) muscle.
Different frequencies have different effects; low frequencies (1-10 Hz) coupled with long impulse times, for example, have a purifying and relaxing effect through individual contractions, whereby the circulation in the treated muscle is simultaneously improved and removal of metabolic end products is supported (lymphatic drainage). The oxygen supply to the muscle is improved.
In contrast, by means of a rapid succession of contractions (fibrillation), medium frequencies (20-50 Hz) can put a high level of strain on the muscle, thus promoting the muscular structure.
Each preset programme has a specific frequency and pulse width that will offer the best results for the type of incontinence treated.
7. CONTRAINDICATIONS, WARNINGS & CAUTIONS
In this manual:
A Warning is used when failure to follow the instructions may result in serious injury or death.
A Caution is used when failure
to follow the instructions may result in a minor or moderate injury, or damage to the device or other property.
Notes are used to provide
clarification or
recommendation.
CONTRAINDICATIONS:
Do NOT use if you are or may be
pregnant. It is not known whether
TENS may affect foetal development.
Do NOT use with optional electrode
pads if you have a pacemaker (or if you have a heart rhythm problem) or with any electronic medical devices.
Using this unit with electronic medical devices may cause erroneous operation of the device. Stimulation in the direct vicinity of an implanted device may affect some models. Stimulation on the front of the neck can affect your heart rate. Very strong stimulation across the chest may cause an extra heartbeat.
Do NOT use in the first 6 weeks
following a pelvic surgery or vaginal childbirth. Stimulation may disrupt the healing process.
Do NOT use if you have symptoms
of active urinary tract infection, vaginal infections, or localized
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lesions. Introducing the probe may irritate sensitive tissue.
Do NOT use if you have poor sensation in the pelvic region. You
may not be able to control the intensity of stimulation safely.
WARNINGS:
Do NOT use if you are unable
to properly insert the vaginal or anal probe. If you have a severe prolapse, or if any discomfort occurs when inserting the probe, consult your healthcare professional before use.
Do NOT use when driving,
operating machinery, or similar actions needing muscular control. Loose electrode pads,
damaged leads, or sudden changes in contact may cause brief involuntary muscle movements.
Do NOT use to mask or relieve
undiagnosed pain. This may
delay diagnosis of a progressive condition.
Do NOT use if you have, in the
area being treated: active or suspected cancer or undiagnosed pain with a history of cancer. Stimulation
directly through a confirmed or suspected malignancy should be avoided as it may stimulate growth and promote spread of cancer cells.
CAUTIONS:
Caution should be used if you
have suspected or diagnosed epilepsy as electrical stimulation may affect seizure threshold.
Caution should be observed
when using the device at the same time as being connected to
monitoring equipment with body worn electrode pads. It may interfere with the signals being monitored.
Caution: Simultaneous
connection to high frequency surgical equipment may result in burns and damage to the stimulator.
Caution: Strong
electromagnetic fields (electro­surgery/ microwave cookers/ mobile phones) may affect the correct operation of this unit. If it appears to behave unusually, move it away from these devices.
Caution Do not permit use by persons unable to understand
the instructions or persons with
cognitive disabilities, i.e.; Alzheimer’s
disease or dementia.
Caution: Insertion of the
vaginal or anal electrode makes it unsuitable for use in children without clinical supervision
Caution: Keep away from
children under 5 years of age.
Long cord - risk of strangulation in infants.
Caution should be observed
when using the itouch sure at high strength settings. Prolonged use at high settings may cause muscle injury or tissue inflammation.
Note: No serious or long term adverse effects have been
reported. Mild adverse reactions are very rarely reported, but these have included muscular pain and cramps, vaginal tenderness, irritation and bleeding, mild or short term urge or faecal incontinence, and tingling sensation in legs. If you experience any of these, stop use. When symptoms have gone, try resuming at a lower intensity setting.
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PROBE CAUTIONS:
Caution: The itouch sure
vaginal probe is intended for single patient use only. Do not share your itouch sure probe with anyone else. Improper treatment or cross- infection may occur.
Caution: It is important that the
vaginal probe is cleaned after each use. Ineffective cleaning may lead to irritation or infection.
Caution: Never insert or
remove vaginal probe unless the control unit is powered OFF as insertion or removal when stimulation is active may cause discomfort or tissue irritation.
Caution: If tissue irritation
occurs, discontinue treatment immediately. Ask your healthcare
professional for advice before continuing further treatment to prevent injury.
Caution: Do not use a silicone
based lubricant on the metal plates of the probe as it may decrease the effectiveness of itouch sure’s muscle stimulation.
Caution: The stainless steel in
the probe’s metal plates contain some Nickel. This could cause a reaction if you have a Nickel allergy.
Alternative gold probe specially made without Nickel is available (see X-VPG).
Caution should be used if you
have a copper IUD. If discomfort occurs, discontinue treatment immediately and ask your healthcare professional for advice.
There is a small risk of stimulating the uterine wall if the IUD is not correctly positioned.
Caution: Do not use this device with vaginal probe or
anal probe other than those recommended by the manufacturer in section 17. Electrodes with smaller surface area may cause tissue irritation.
DO NOT PLACE OPTIONAL ELECTRODE PADS:
On skin, which does not have normal
sensation. If the skin is numb too
great a strength may be used, which could result in skin inflammation.
On broken skin. The electrode pads
could encourage infection.
ELECTRODE PADS CAUTION:
Caution: Do not ignore any
allergic reaction to the electrode pads: If a skin irritation
develops, stop using TENS, as this type of electrodes may not be suitable for you. Alternative electrode pads specially made for sensitive skin are available (see E-696-SS).
Caution: Do not use this
device with leads or electrode pads other than those recommended by the manufacturer. Performance
may vary from specification. Electrodes with smaller surface area may cause tissue irritation.
TO KEEP YOUR DEVICE IN GOOD WORKING ORDER, OBSERVE THE FOLLOWING ADDITIONAL CAUTIONS:
Caution: Do not immerse your
device in water or place it close to excessive heat such as a fireplace or radiant heater or sources of high humidity such as a nebulizer or kettle as
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this may cause it to cease to operate correctly.
Caution: Keep the device
away from sunlight, as long­term exposure to sunlight may affect the rubber causing it to become less elastic and crack.
Caution: Keep the device
away from lint and dust, as long-term exposure to lint or dust may affect the sockets or cause the battery connector to develop a bad contact.
Caution: Temperature &
Relative Humidity of storage: ­10°C to +60°C, 8 to 93% R.H. Temperature & Relative Humidity of operation: 0°C to +40°C, 10 to 93%
R.H.
Caution: Do not attempt to open or modify the TENS unit. This may
affect the safe operation of the unit and will invalidate the warranty.
8. INFORMATION ABOUT THE PROGRAMME SETTINGS
Each programme has its own combination of Frequency and Pulse Width settings which allow for different sensations through the probe or optional electrode pads and help treating the different types of incontinence.
Frequency (measured in Hz -
pulses per second)
Low frequencies (1-10 Hz) have a purifying and relaxing effect through individual contractions.
Medium frequencies (20-50 Hz) can put a high level of strain on the muscle, thus promoting the muscular structure
Pulse Width (measured in μs -
millionths of a second)
The itouch sure unit has pulse widths of 200 to 300 μs. Generally speaking, the higher the pulse width, the more "aggressive" the stimulation feels, if the pulse width is set high enough, it will usually elicit a muscle contraction, which is required for an effective toning of the pelvic floor muscles.
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9. PROGRAMMES
9.1. PROGRAMME SETTINGS
9.2. PRESET PROGRAMMES
The itouch sure has 4 preset programmes. One for each type of incontinence (stress, urge and mixed), and one aftercare programme for toning the pelvic floor muscles (TONE).
STRESS INCONTINENCE:
Shown on the screen as: STRES The STRES incontinence programme
strengthens the muscles of the pelvic floor using gentle stimulation. Once these muscles are stronger they are better able to resist urinary leakage caused by external pressure being applied to the bladder such as with a cough, sneeze or physical exertion.
The stimulation causes the muscles to contract and work. This builds their strength. Like other fitness training,
successful treatment requires stimulation once a day for one to three months. Improvement starts becoming apparent after about four weeks.
The sensation is like a strong drawing in of the muscles of the vagina, pulling up the pelvic floor. Your natural reaction will be to pull your muscles in and up, and this exercises and strengthens them.
URGE INCONTINENCE:
Shown on the screen as: URGE The URGE programme works in a
different way to the STRES programme. The gentle continuous stimulation soothes the bladder (detrusor) muscle, reducing its involuntary contractions. This prevents the unwanted and unexpected emptying of the bladder.
Successful treatment requires stimulation once a day and improvements can sometimes be seen in as little as two weeks.
The sensation is a softer, vibrating, stimulation. Nevertheless, when the programme finishes, and your pelvic floor relaxes, it will become apparent how much your pelvic floor has been exercised.
MIXED INCONTINENCE:
Shown on the screen as: MIXED This programme is perfect if you are
suffering from both Stress and Urge incontinence. It is a combination of the
STRES and URGE programmes.
Prog
STRES
URGE
MIXED
TONE
Freq.
(Hz)
50
10
20
35
Pulse width
(μs)
300
200
250
250
Ramp Up
& Down
(s)
1 1 2
2
Plateau
(s)
5 5 3
3
Rest (s)
10
10
20
6
Default
duration
(min)
20
20
20
20
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TONE:
Shown on the screen as: TONE Once the pelvic floor muscles have
been strengthened with itouch sure, continue to exercise them.
Regular use of this programme, about twice a week, will ensure that your muscles remain fit and toned.
The TONE programme may also be used as an alternative treatment for stress incontinence.
The sensation when using the TONE programme is a mixture of a strong drawing in of the muscles and then releasing.
A strong and fit pelvic floor may increase sexual health and enjoyment.
10. CONTENT
The pack contains:
1 x itouch sure continence
stimulator unit
1 x Lead wire (L-IT1-NEW)
1 x Liberty vaginal probe (X-VP)
2 x AA 1.5V alkaline batteries
1 x Storage pouch
1 x Instructions for use booklet
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11. UNIT INFORMATION
11.1. CONTROLS & DISPLAY
Programme selected
Programme selector
Time selector
OFF button
ON button
Lock button
Time remaining (min)
Strength selected (mA)
Strength up
Strength down
Low Battery
Output active indicator
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11.2. OPERATING INSTRUCTIONS
ON/OFF
To turn the unit on, press the ON button and hold for 3 to 5 seconds until the display shows.
At first use, or after changing batteries, the display shows that the unit is automatically set in programme STRES at zero strength.
When switched on the unit will automatically start in the programme which was being used when it was last switched off.
The strength returns to 50% of the level that was being used when the unit was switched off.
During start up to stop the increase in strength at any time, press any key once.
To turn the unit off, press the OFF button and hold for 3 to 5 seconds until the display stops.
Alternatively, press and release the OFF button until the LCD screen displays 0, any further press will switch the unit off.
The unit will turn off automatically:
When the timer reaches zero,
If it is left at zero strength for more
than 5 minutes.
Note: Always check unit is OFF before applying or removing probe or pads.
The screen is illuminated whenever a button is pressed.
STRENGTH CONTROLS
The buttons marked and ▼ are the strength controls.
To increase strength, press and hold down the button until required strength is
achieved. To decrease the strength, press and
release the button . To increase strength in steps of 0.5 mA,
press and release the button . The unit will remain in the WORK part
of the cycle for 5 seconds while intensity is being adjusted.
The strength levels are shown on the LCD.
The strength control buttons will not operate until the unit is properly connected to you (probe inserted correctly). Itouch sure detects a disconnection and automatically returns the strength to zero.
The unit has 198 levels of strength (0 to
99.5 mA). If you hold down the button for 3 to 5 seconds, the strength will start scrolling.
You may feel nothing over the first few presses. Continue pressing until the sensation is strong but comfortable. Further increases during use may be necessary if your body becomes used to the sensation.
PROGRAMME CONTROL
The button marked P is the
programme control. The itouch sure has four preset programmes. At first use, the unit automatically goes to programme
▲ ▼
P
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STRES. Next time it is switched on, it
will default to the programme used last. Each time you press and release the P
button, the programme changes and is shown on the LCD.
Each time you change the programme, the strength level reverts back to zero. This is a safety feature to alleviate any sudden feeling of a surge, as each programme gives a different sensation.
TREATMENT TIMER
The TIMER button can be
used to set the session duration. When you switch the unit on, it is automatically set at 20 minutes for all the programmes.
By repeatedly pressing and releasing the TIMER button you can manually override and select 10, 30, 45, 60, 90 minutes or continuous time.
The length of time that you have selected will be shown on the screen. The minutes will start to count down once you start the programme.
If you hold down this key for 3 to 5 seconds, you can PAUSE the timer, allowing you to interrupt the treatment session, and resume it later. Return to main screen by pressing any other key.
The LCD shows the session duration next to the clock symbol. The unit automatically counts down the minutes set and switches off when it reaches 0.
LOW BATTERY
A low battery indicator BATT will show when you need to change the batteries. The unit will shut down about 2 minutes after this.
LOCK BUTTON
The LOCK button on the top right hand side of the unit can be used to lock all controls except for the and OFF buttons.
To activate, press and hold down the button for 3 to 5 seconds until LOCK is displayed on the screen. Repeat to deactivate.
LEADS ALARM
The itouch sure monitors the connection and the contact between you and the probe, or the pads. This is to prevent sudden changes if a broken connection is re-made. If either of these goes outside of a standard range while the strength is above 20.0 mA, the unit will flash LEADS, bleep three times, and return the strength to 00.0 mA.
Check the lead and if necessary, lubricate the probe with a water based lubricant such as TensCare Go Gel (see K-GO). Please see section 19 for more troubleshooting tips.
MEMORY
The itouch sure has a Memory with three functions:
1) Programme Retention. When you switch the unit on, it will automatically start in the programme which was being used when it was switched off.
2) Usage. Press the TIMER button and together and hold down for 3 to 5 seconds. The display will show the duration of use in hours and the average strength used.
Press the same buttons again to return to normal controls.
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3) Memory Reset. To reset memory to zero, hold down the TIMER and buttons together for 3 to 5 seconds.
12. SETTING UP AND
USING THE ITOUCH SURE
12.1. INSTALLATION OF
BATTERIES
1) Remove the battery cover: Press
down in the centre and slide backwards in direction of raised arrows.
2) Insert batteries: Ensure that the
batteries are inserted the right way as shown in battery compartment and that the ribbon is behind them.
3) Replace the battery cover.
When the batteries are running low, a low battery indicator BATT will show on the screen and it is important to change the batteries as soon as possible.
Rechargeable batteries
The unit will work with rechargeable batteries, but the display may appear dim.
Storage Remove batteries from your itouch
sure if the unit is unlikely to be used for
a long period. Some types of batteries may leak corrosive fluid.
Battery Life
Batteries should last at least 15 hours at 50 mA, 300 μs, 50 Hz.
Unused batteries have a nominal shelf life of 3 years, but will usually last longer than this.
Battery Warnings
Do NOT pierce, open,
disassemble, or use in a humid
and/or corrosive environment.
Do NOT expose to temperatures over 60°C(140F).
Do NOT put, store or
leave near sources of heat, in direct strong sunlight, in a high temperature location, in a pressurized container or in a microwave oven.
Do NOT immerse in water or
sea water, or get wet.
Do NOT short-circuit.
Do NOT connect the device
unless the battery cover is in
place.
If battery leakage occurs and comes in contact with the skin or eyes, wash thoroughly with lots of water.
Average strength used
Time used in hours
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Keep batteries out of the reach of small children.
Caution NEVER attempt to recharge an alkaline battery. Risk of explosion.
Caution Do not mix old, new or
different types of batteries as this may lead to battery leakage or low battery indication.
Disposal: Always dispose of batteries responsibly according to local government guidelines. Do not throw batteries onto a fire. Risk of explosion.
12.2. CONNECTING LEAD
WIRE
Insert the lead wire plug into the base of the unit.
Connect the lead from the base of the unit to the lead in the probe.
Push the pin ends firmly into the pigtail ends of the probe lead.
The lead wires may be damaged by rough handling, and should be treated with care.
Lead wire colour coding.
The ends of the lead wire are coloured black or red. This coding is provided for some professional uses. For most purposes, the orientation makes no difference, and you can ignore this colour coding.
12.3. PREPARING FOR SESSION
1) Before using itouch sure you will
need to visit the toilet.
2) Lubricate the metal electrode
surfaces and probe tip with a water­based lubricant, such as TensCare Go Gel or water (see K-GO).
Caution: Do not use a silicone based lubricant on the
stimulation contacts as it may decrease the effectiveness of the itouch sure’s muscle stimulation.
3) Choose a comfortable position, such
as lying down on your bed on your side with your knees raised.
Warning: Ensure that the
itouch sure is switched OFF
before inserting the probe.
4) After the wire is securely connected,
insert the probe into your vagina, in
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the same way as you would a tampon, until only the plastic rim at the base of the probe is visible.
5) The metal parts conduct the electrical pulse and should be in contact with the main part of the muscle at all times. The tissues close to the entrance are more sensitive, so you should avoid stimulating them.
Ensure that the probe is aligned so that the contact plates are to the sides and the longer sides of the positioning end rim are vertical. The probe will naturally position itself with the widest part of the flange vertically.
Note: The flange should not be
inserted into the vagina and should remain outside of the vagina at all times.
12.4. TRAINING SESSION
1) Press and hold the ON button on the
control unit for 3 to 5 seconds to switch the control unit on.
2) You can select from the four preset
programmes. Details in section 9 will help you identify the best programme to suit you. To change between the programmes, press the programme selector, which is labelled P, in the centre of the control unit keypad.
3) With the required programme selected, you can adjust the intensity of the muscle stimulation until you reach a comfortable level. Once you have reached a comfortable level, 5 seconds after you stop pressing the button, the intermittent work/rest phase will start. The machine will take itself to 0 mA for a rest period and then take itself back up to the level of intensity you chose, to work the muscle. This cycle will continue for the 20 minutes of the programme.
Note: The strength required
varies widely between users ­some will use the itouch sure at full power – 99.5 mA. The itouch sure strength will go up at 0.5 mA increments.
Initially the sensation through the probe may be limited but will improve during treatment. Take care not to use too much strength and thereby over stimulate the muscles until normal sensation is restored. The sensation may not be even as it may vary depending on the sensitivity of the nerves.
The LCD display shows the strength of intensity used. The aim is to increase this over a few days. But remember there is no hurry, so only increase the strength of the stimulation as and when you are comfortable and ready to progress.
Note: If the sensation becomes uncomfortable, reduce the intensity using the button .
Metal contact Vertical plates flange
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When switched on, in STRES and TONE programmes the unit will go
through an exercise programme for 4-5 seconds, followed by a rest period of 8­10 seconds. The itouch sure causes a sensation which feels like a strong drawing in of the vagina and pulling up of the pelvic floor. The natural reaction will be to pull in and up with the muscles.
At lower strength settings, you may not feel any sensation at all, this depends very much on the individual and any pre-existing physical conditions, so slowly increase the intensity by
repeatedly pressing the ▲ button until
you begin to feel the muscles around your vagina contract.
For best results in these programmes try to contract the pelvic floor muscles along with the itouch sure, and to sustain the contraction into the rest interval. If possible, link the contraction to your breathing to get into a gentle rhythm.
Increase the strength as high as it is comfortable, and then take it back down one step.
The strength display on the control unit will reduce to 00.0 mA and flash during the rest period.
The URGE programme works differently. There is no need to have a contraction. The strength should be comfortable, but always remain noticeable. You may need to increase it over the course of the treatment.
The length of each session is automatically set to 20 minutes. The length of each session for muscle strengthening will also depend on your
ability to contract and your resistance to fatigue. Be careful not to overuse early on, as the resulting aches may not be felt until the next day.
Note: If you experience
cramping, switch the unit off
until the symptoms go away then continue the session with the intensity set at a lower level.
Optional skin surface electrode placement for URGE
An alternative method to a vaginal probe is to stimulate areas of the skin that are close to the nerves that go to the bladder and urethra. These come from the parts of the spinal cord segment called S2-S3.
The electrodes are placed on the skin between the anus and the genitals, or at the very bottom of the spine near
your coccyx or “tail”. See electrode
placement pictures below.
The stimulation should be strong enough to make your anus contract slightly.
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12.5. AFTER YOUR TRAINING SESSION
When the timer reaches zero, your session is complete and the unit turns off.
1) Check that the control unit is off. If it
is not, hold down the OFF button to switch off then remove the probe from your vagina by holding the positioning end rim and gently pulling outwards.
2) Wash and thoroughly dry the probe
and return it to the storage pouch.
3) The itouch sure will not only
improve your pelvic floor muscles but also help you to recognise the correct sensation you need to feel when doing your Kegel exercises (explained in section 4.2.).
Note: When removing the probe, DO NOT PULL ON THE LEAD WIRE.
13. ANAL PROBE
13.1. CONDITIONS THAT MAY BE TREATED
An anal probe such as TensCare X­PR13 can be purchased. This probe
can be used for urinary and faecal incontinence in both males and females.
This anal probe may be used to treat Urinary and Faecal Incontinence in a similar way to the vaginal probe. Because the stimulation cannot be restricted to one muscle group, and the mucosal tissue has different electrical characteristics, anal stimulation is less comfortable than vaginal.
You should consult your healthcare professional before starting treatment.
Faecal Incontinence
Faecal incontinence can be the result of weakened or poorly functioning anal sphincter muscles or damage to the nerves controlling them. The purpose is to re-educate the anal sphincter and other muscles of the pelvic floor to contract. The treatments aim to progress towards graduated active exercises, in order to improve pelvic floor muscles’ strength and endurance and to regain function.
You may benefit from the itouch sure if you either have no active anal sphincter contraction, or a weak or poorly sustained contraction. Use the STRES or TONE programmes. Intensity should be as strong as possible without being painful. When possible, try to contract the muscles at the same time as the itouch sure.
Post Prostatectomy Urinary Incontinence
Electrical stimulation has been found to help urinary incontinence in men after radical prostatectomy in some trials. Use the same programmes as for vaginal stimulation. Increase intensity in STRES, MIXED, or TONE programmes to the highest tolerable.
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13.2. HOW TO INSERT THE ANAL PROBE
1) Before using itouch sure you will
need to visit the toilet.
2) Lubricate the metal electrode
surfaces and probe tip with a water­based lubricant, such as TensCare Go Gel or water (see K-GO).
Caution: Do not use a silicone based lubricant on the
stimulation contacts as it may decrease the effectiveness of the itouch sure’s muscle stimulation.
3) Choose a comfortable position, such
as lying down on your bed on your side with your knees raised.
Warning: Ensure the itouch
sure is switched OFF before
inserting the probe.
4) After wires are securely connected,
insert the probe into the anus whilst
‘bearing down’ (as in the action of
passing stool) to a comfortable limit until the base of the flange on the probe touches the anus. The metal parts conduct the electrical pulse and should be in contact with the main part of the muscle at all times. The tissues close to the entrance are more sensitive, so you should avoid stimulating them. It is recommended that the probe is inserted past the sphincter muscles of the anus, unless directed otherwise by a healthcare professional.
5) Anal probes with long electrodes (the
metal part) that run up and down the length of the attachment should
always be inserted with the metal parts facing hip-to-hip. Anal probes with circular electrodes (the metal part) should be inserted simply to the desired depth.
Note: Sometimes the wearing of tight fitting undergarments or
a tight pair of jeans will help to keep the probe in place and maintain correct contact during the programme.
For Faecal incontinence, the aim is to stimulate the external sphincter and/or pubo-rectal muscle, so circular electrodes should be placed so that the external ring is just inside the sphincter.
For Urinary Stress incontinence, the aim is to stimulate the levator muscles and the probe should be inserted deeper.
14. CLEANING
It is important that the probe is cleaned after each use. Clean with either an alcohol-free antibacterial wipe such as TensCare Wipes (see X-WIPES) or by wiping with warm soapy water. Rinse and dry thoroughly and return the unit to the storage pouch. Do not immerse the probe in a liquid.
Clean the case of the unit and lead wire at least once a week using the same method.
Do not immerse your itouch sure
unit in water.
Do not use any other cleaning
solution.
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15. EMC
Wireless communications equipment such as wireless home network devices, mobile phones, cordless telephones and their base stations, walkie-talkies can affect this equipment and should be kept at least a distance d = 3,3 m away from the equipment.
(Note. As indicated in Table 6 of IEC 60601-1-2:2007 for ME EQUIPMENT, a typical cell phone with a maximum output power of 2 W yields d = 3,3 m at an IMMUNITY LEVEL of 3 V/m).
Note: For hospital use, full EMC advice tables are available on request.
16. DISPOSAL OF WASTE ELECTRICAL AND ELECTRONIC PRODUCTS (WEEE)
One of the provisions of the European Directive 2002/96/CE is that anything electrical or electronic should not be treated as domestic waste and simply thrown away. To remind you of this Directive all affected products are now being marked with a crossed-out wheelie bin symbol, as depicted below.
To comply with the Directive, you can return your old electro-therapy unit to us for disposal. Simply print a postage­paid PACKETPOST RETURNS label from our website www.tenscare.co.uk, attach this to an envelope or padded bag with the unit enclosed, and post it back to us. Upon receipt, we will process your old device for components recovery and recycling to help conserve
the world’s resources and minimise
adverse effects on the environment.
17. ACCESSORIES
Expected Service Life
The machine will often last for more than 5 years, but is warrantied for 2 years. Accessories (lead wire, probe, and batteries) are not covered by the warranty.
Lead life depends greatly on use. Always handle the leads with care. We recommend to replace the lead wires regularly (about every 6 months).
Replace the probe every 6 months to ensure hygiene.
Optional electrode pads should last 12-20 applications, depending on skin condition and humidity.
AA alkaline batteries should last at least 15 hours at 50 mA, 300 μs, 50 Hz.
Replacement electrode pads, new batteries and lead wires are available from your supplier or distributor (see back cover for contact details), by mail order from TensCare, by telephone using a credit or debit card, or through the TensCare website.
The following replacement parts may be ordered from TensCare at www.tenscare.co.uk or +44(0) 1372
723434.
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X-VP Liberty Vaginal Probe (28
mm dia.)
X-VPM Liberty Plus Vaginal
Probe (32 mm dia.)
X-VPG Gold Vaginal Probe (26
mm dia.)
L-IT1-NEW Replacement lead wire,
1.25 m length X-PR13 Anal probe (19.6 mm dia.) E-CM5050 Pack of 4 electrode pads
(50x50 mm)
K-GO Go Gel Personal Water-
based Lubricant B-AAA-8 8 AA batteries 1.5V X-WIPES Pack of 30 wipes
Note: You should only use the probe supplied with the unit or
the replacements above as performance may vary with other electrodes.
Warning: Do NOT use silicone
based or hybrid (mixed water
and silicone) lubricants.
CHANGE OF LEAD
Please note that from serial number E14/009931 (since 2014) the itouch sure has an all-plastic connecting plug on the lead to comply with current safety regulations. Please ensure that you purchase the replacement lead L­IT1-NEW, see picture below.
The connection to plug into the unit is made of plastic (not metal).
18. WARRANTY
This warranty refers to the unit only. It does not cover, electrode pads, battery, or the lead wires.
PRODUCT WARRANTY INFORMATION
This product is warranted to be free from manufacturing defects for 2 years from date of purchase.
This warranty is void if the product is modified or altered, is subject to misuse or abuse; damaged in transit; lack of responsible care; is dropped; if incorrect battery has been fitted; if the unit has been immersed in water; if damage occurs by reason of failure to follow the written instruction booklet enclosed; or if product repairs are carried out without authority from TensCare Ltd.
We will repair, or at our option replace free of charge, any parts necessary to correct material or workmanship, or replace the entire unit and return to you during the period of the warranty. Otherwise, we will quote for any repair which will be carried out on acceptance of our quotation. The benefits conferred by this warranty are in addition to all other rights and remedies in respect of the product, which the consumer has under the Consumer Protection Act
1987.
Our goods come with guarantees that cannot be excluded under the UK consumer Law. You are entitled to have
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the goods repaired or replaced if the goods fail to be of acceptable quality.
Before you send your unit for service
Before sending in your unit for service, please take a few minutes to do the following:
Read your manual and make sure you follow all the instructions.
Returning your unit for service Should repair be needed within the
warranty period, enclose the tear off section of the warranty card (see page
32) and your proof of purchase receipt. Please ensure all relevant details are completed before sending your unit in for service. Please ensure your contact details are still current and include a brief description of the problem you are experiencing together with your purchase receipt.
For hygiene reasons, please do not include used probe or electrode pads. Send only the unit and the lead wire.
Please return the unit and warranty card (see page 32):
TensCare Ltd
PainAway House, 9 Blenheim Road, Longmead Business Park, Epsom, Surrey KT19 9BE, UK
Should you require any further information please do not hesitate to contact us by calling our number:
+44 (0) 1372 723 434.
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19. TROUBLESHOOTING
If your itouch sure is not working properly, please check the following:
Problem
Possible causes
Solution
No display
Flat batteries.
Replace batteries.
Batteries inserted incorrectly.
Remove plastic wrap Check + / - .
Damaged springs in battery compartment.
Contact supplier.
Low battery display
Low batteries.
Replace batteries.
Controls won’t
work
Keypad is locked.
If LOCK is shown on display, press and hold the LOCK button for 3 to 5 seconds to unlock.
If no LOCK is showing, remove and replace the batteries.
No sensation and LEADS alarm showing
The itouch sure has a safety feature which will not allow the intensity to pass
20.0 mA if the machine detects a connection error. If a connection error is detected the intensity will return to 00.0 mA and the screen will flash LEADS. This safety feature will prevent the machine from giving any uncomfortable stimulation should the contact break between the machine and your skin. This will also prevent anyone from increasing the intensity to a high level without firm contact between the machine and the skin.
A connection error can occur if:
1. A break has developed within one of the two lead wires.
If this happens, you can try to test the unit by holding the probe in your hand:
i) Dampen your hand with water and a little table
salt. Squeeze the probe firmly and make sure your skin is covering the metal parts of the probe and carefully increase strength until you can feel something. Most people will start to feel the stimulation in their hand at around 25.0 mA.
ii) If the LEADS alarm shows and the unit will not
allow you to pass 20.0 mA. The lead wires need to be replaced.
If you have tried the test above and DO have sensation when the probe is in your hand, then it may be that:
2. The skin is dry, meaning poor conductivity between the metal plates
If this happens, you can try the below solutions: i) Using a water–based lubricant such as
TensCare Go Gel (see K-GO), which will improve conduction.
ii) Crossing your legs and squeezing to increase
pressure on the probe, which should improve the connection. If this enables you to use the unit, you should find that in a few weeks of
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on the probe and your skin.
stimulation the contact improves. If it does not, this unit may not be suitable for you. You may need to contact your healthcare professional to discuss other suitable options.
iii) The probe supplied with the unit has a 28 mm
diameter. An optional 32 mm probe, part no. X-
VPM, is available.
No sensation and no LEADS alarm showing
Intensity level is not high enough and/or reduced sensitivity in the area being treated.
i) Please make sure you are increasing the
intensity high enough. Most people will start to feel the stimulation in their hand at around 25.0 mA and with the probe inserted you will need to increase the intensity higher to around 40.0 mA to 60.0 mA. Max power is 99.5 mA. Everyone is different so just keep increasing the intensity until you can feel it. The intensity increases in very small steps of 0.5 mA.
ii) You may have reduced sensitivity due to
previously damaged or desensitised pudendal nerves (this can happen in childbirth or some surgical procedures). Please consult your healthcare professional.
No sensation on one side of the probe (or electrode)
Position is not optimal – needs adjusting.
The current flows from one side of the probe to the
other, so it is not possible to have one side “not working”. However, the strength of the sensation
depends on how close to the nerve the current flows, and also in which direction it flows relative to the nerve. You can try slightly adjusting the position on the probe, or exchanging the connection of the wires in the probe.
Sudden change in sensation
If you disconnect and re­connect a few minutes later, the signal will feel quite a lot stronger.
Always return strength to zero after disconnecting the lead or the probe.
The patient is an intended operator. There are no user-serviceable parts inside the unit, and no calibration is required.
If the above review has failed to resolve your problem, or to report unexpected operation or events, call TensCare or your local dealer (address on back cover) for advice.
Contact TensCare customer service on +44 (0) 1372 723 434. Our staff are trained to assist you with most issues you may have experienced, without the need to send your product in for service.
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20. GENERAL SPECIFICATION
Waveform
Asymmetrical rectangular
Amplitude (over 500 Ohm load)
99.5 mA +/- 10%
Max intensity
50V zero to peak Constant voltage over 470-1500 Ohm Constant current over 160-470 Ohm
Output plug
Fully shielded
Channels
Single channel
Max Pulse energy
Total output limited to 25 μC per pulse
Batteries
2 x AA alkaline (two AA batteries) or 2 x AA NiMH
Weight
90 gms without batteries
Dimensions
102 x 53 x 30 mm
Safety Classification
Internal power source.
Environmental Specifications:
Operating:
Storage:
Temperature range: 0 to +40C Humidity: 10 to 93% RH non-condensing Atmospheric pressure: 700hPa to 1060hPa Temperature range: -10 to +60C Humidity: 8 to 93% RH non-condensing Atmospheric pressure: 700hPa to 1060hPa
TYPE BF EQUIPMENT
Equipment providing a degree of protection against electric shock, with isolated applied part.
Designed for continuous use.
This symbol on the unit means “Refer to Instructions
for Use”
IP22
The unit is not water resistant, and should be protected from liquids.
Complies with EU WEEE regulations
Applied Part
Vaginal and anal electrodes. Optional skin surface electrode pads. See section 17.
Contact duration: At least 10 minutes.
Note: The electrical specifications are nominal and subject to variation from the listed values due to normal production tolerances of at least 5%.
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PLEASE RETAIN THIS WARRANTY CARD. RETURN THIS PORTION ONLY WHEN YOU RETURN YOUR PRODUCT FOR
REPAIR UNDER WARRANTY.
NAME: ADDRESS:
POSTCODE: DAYTIME TELEPHONE: E-MAIL:
MODEL: DATE OF PURCHASE:
ATTACH PROOF OF PURCHASE
DO NOT SEND IN PROBE OR ELECTRODE PADS
RETAILERS NAME: RETAILERS ADDRESS:
RETAILERS POSTCODE: BRIEF DESCRIPTION OF PROBLEM YOU ARE EXPERIENCING:
WARRANTY IS VOID UNLESS THE ABOVE INFORMATION IS COMPLETED AND CORRECT.
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NOTES
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TensCare aim to give you the best possible product and service. We listen to your suggestions and are constantly trying to improve our products. We also want to learn about the way our products are used, and the benefits they give. If you have anything you would like to share with us, please contact:
www.tenscare.co.uk
Follow us:
https://www.facebook.com/pages/TensCare-Ltd
https://twitter.com/TensCareLtd
https://www.linkedin.com/company/tenscare-limited
https://plus.google.com/+TenscareLtdEpsom
https://uk.pinterest.com/TensCareLtd/
https://tenscareltd.wordpress.com/
https://www.youtube.com/channel/UCzpik9dmLlJ3j0aHOpQ-0sg
EC Declaration of Conformity
TensCare Ltd hereby declare that an examination of the production quality assurance system has been carried out following the requirements of the UK national legislation according to Annex V of the Directive 93/42/EEC on medical devices. We certify that the production quality system conforms with the relevant provisions of the aforementioned legislation, and the result entitles the organization to use the CE 0088 marking on this product.
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Distributed by:
Manufactured by:
TensCare Ltd, 9 Blenheim Road, Epsom, Surrey KT19 9BE, UK Tel: +44(0) 1372 723434 www.tenscare.co.uk
Pub No.: I-ITS-UK Version 4.1 05/17
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