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Trans Prostate Electrical Stimulation combines elements of
urethral, anal, and electrical stimulation. As such it can be a source of great pleasure to the recipient, but
it also challenges the skill of the giver. Knowledge and skill are required in all three areas.
The directions and supplies list below are detailed.
Don't let this discourage you. The completeness of the plan is designed
to maximize satisfaction and minimize unwonted side effects.
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Pictures
These pictures where taken with an additional
fenestrated drape (green) underneath the sterile drape (white). Since
the green drape was not sterile, it adds nothing to the procedure except
a note of clinical authenticity. Its use is not provided for in the
steps below.
Warnings
-
Be exceedingly careful not to jar things once the
T.E.N.S. unit is turned on. The alligator clips are not an ideal way
to make the connections, but they are the only practical way.
Disrupting the electrical connections while the unit is on can cause
an unpleasant shock. You might even see a spark. There is little
possibility of harm, except that your recipient may want to quit
right then.
Always turn the unit off before making any adjustments.
If the recipient is not feeling anything, suspect your connections.
Turn the unit off and exam everything carefully. Reseat the
connections as necessary.
-
The possibility of contamination of the urinary
tract is higher than in procedures involving only the urethra. Even greater care than normal is required to prevent accidental infection of the urinary track with germs from the intestinal track.
-
Effects of long term usage of this procedure are
unknown.
Steps
-
Secure all the necessary equipment and supplies as listed below.
-
Wash hands thoroughly. Be sure to scrub finger nails, web between fingers, and up the
arms up to the elbow.
-
Have the recipient lie flat on his back on a padded
surface with legs spread.
-
Don a pair of examination gloves.
-
Wash the entire crotch area including the anus with warm soapy water.
Rinse thoroughly with plain water to remove all soap. Dry.
-
Apply a coating of lubricating jelly to the end of the anal electrode. Set between legs for quick access.
-
Apply a dab of lubricating jelly to the anus and to
your finger. Massage gently with the pad of the finger until the area is well relaxed. Slip finger into anus and continue massage. When sphincter is well relaxed, remove finger and slip in anal electrode. Make sure that external end of electrode is
free to move, i.e. not touching or being pressed by anything.
-
Discard the gloves and don a new pair. See notes.
-
Prepare a fenestrated drape by folding a Benzalkonium
chloride wipe in quarters and sniping about 1/2 inch from the folded point. This will put a window
or fenestra in the middle of the wipe. Slip the wipe over the penis.
-
Scrub the entire shaft of the penis with a fresh Benzalkonium
chloride wipe.
-
Scrub the meatus (head) of the penis with Povidone-iodine
wipe.
-
Fill syringe with contents of one packet or tube of sterile
lubricating jelly. Inject jelly into the urethra.
-
Instruct recipient that he is to hold flat area of sound after insertion and until procedure is completed.
Instruct him further not to press the sound in and not to touch the
round portion of the sound.
-
Dab lubricating jelly onto sound. Insert into urethra. Penis must be
flaccid. If using a van Buren Sound (curved) hold penis perpendicular to body to insert. Then move penis so that it is pointed toward navel to allow the curve of the sound to pass further in. Do not force the sound. Let gravity do the work. Constantly check on patient comfort. When well in pass flat end to patient.
-
Hook electrodes from T.E.N.S. unit to flat end of sound and to end of anal electrode.
Double check the connections to make sure they are securely
fastened. See warning 1 above.
-
Set T.E.N.S unit to burst mode and short pulse width. Turn unit on and slowly increase amplitude, constantly checking for recipient. When amplitude is correct, anus will pulse regularly.
If you desire to experiment with the other T.E.N.S. unit modes -
normal and modulated - turn the unit off before changing mode. See
warning 1 above.
-
When done, turn off T.E.N.S. unit, remove electrodes, remove sound,
remove anal electrode, clean penis, clean anus.
Supplies
For washing giver's hands
□ Running water
□ Anti-bacterial hand soap
□ Finger nail brush
For washing and drying recipient
□ Dr.
Bronner's Castile Soap. See Dr.Bronner's Castile Soap
Documentation
□ Container of hot soapy water for washing. Use a squirt of
Dr. Bronner's Castile Soap.
□ Container of hot water for rinsing.
□ Five small cloth towels or roll of paper toweling. Three
are needed during preparation (wash, rinse, dry) , and two are used for
cleanup (wash, dry).
To protect the giver and the recipient
□ Two pair examination gloves
For anal electrode
□ Anal
electrode. These come in small, medium and large. The only issue in
choosing size is the recipient's ability to have it comfortably
inserted.
□ Packet of lubricating jelly. See notes.
For urethral electrode
□ Sterilized Van
Buren Sound sized to comfortably pass the urethra. Use the largest
that the recipient can comfortably pass. Sounds must be autoclaved and
stored in sterile packaging or sterilized in a pressure cooker
immediately before use. If using a pressure cooker, allow time for
cooling.
□ One tube of sterile lubricating jelly. See notes.
□ One new single use syringe. See notes and illustration
□ One pair of scissors.
□ One Benzalkonium chloride wipe cut with hole. See
illustrations.
□ One Benzalkonium chloride wipe to clean shaft of penis.
□ One Povidone-iodine wipe to clean head of penis.
For electrical stimulation
□ One T.E.N.S.
unit with spare 9 volt battery.
□ One pair of test leads with alligator clips on both ends.
For supporting the recipient and supplies
□ Exam, massage or other padded table with pillow. The
top of the padded portion should be about 33 inches above the floor.
This positions the recipient in a comfortable position for giver to
perform the procedure
Options
□ Mirrors above and at end of exam table allow the recipient to
watch what you are doing.
□ Control of sight and hearing through any of the
following:.
+ Southing music
+ Dim room lights once the T.E.N.S. unit is running
+ Sleep mask
+ Sensory depravation device
Notes
Examination gloves: Sterile gloves are used in a
clinical setting. However in other settings wiping the finger tips with Benzalkonium
chloride wipes before handling the sound should be adequate. For more
information, see Antiseptic Technique below.
Removing examination gloves: Develop a habit of
removing the gloves in such a way as to minimize self-contamination.
Assuming the right hand glove is the most contaminated, pull it off with
the left hand starting at the wrist and pulling it over itself. Holding
the dirty glove in the left hand, use the right hand to pull off the
left glove from the wrist and over the other glove. This leaves a ball
of gloves with a clean side out.
Lubricating jelly: Use only unopened packets or one use tubes of
sterile lubricating jelly for this procedure. Separate containers
should be used for anus and penis to prevent cross contamination.
See illustration.
Filling syringe with lubricating jelly: The small tube of
lubricating jelly is the most convenient way to fill the syringe. Break
off tip of jelly tube. Remove the plunger from the syringe and hold to
keep from contaminating it. Fill syringe from wide end. Replace plunger
and force jelly to working end. You can also use the packet. It is just
more awkward.
A third hand would be useful in juggling the syringe, plunger and tube
of jelly. Get your recipient to help you, or practice until you can do
it without contaminating any of the sterile surfaces.
 Syringe:
Syringes are commonly available with two types of tips for attaching the
needle: Luer regular and Luer lock. (See illustration.) The regular tip
is a truncated cone over which the needle is slipped. The lock tip
requires the needle to be screwed on. Either style may be used to inject
the lubricating jelly into the urethra. The regular style is slightly
preferable because you can slip the tip into the end of the urethra. If
your syringe is of the locking type, the end is too large to insert in
to the urethral opening; just hold it against the end.
Expect some of the injected jelly to ooze out of the
urethra.
Antiseptic technique: Any procedure
involving the urethra must be done with the utmost of care to avoid
infection. The urinary tract is normally sterile with respect to the
recipient. The intestinal tract is full of germs. Because both areas are
involved the possibility of cross infection is much greater than in
procedures involving only one area.
There are several key points to avoid cross infection:
-
A thorough cleansing with soap removes dirt, oils,
residual fecal matter, etc. However, soaps and detergents can reduce
the effects of the antiseptics, and therefore traces must be removed
by a thorough rinsing.
-
Use single use antiseptic wipes. Bottles of
antiseptic can be contaminated! Use each wipe for just one
purpose. See below.
-
Use a a new pair of gloves for each portion of the
procedure as described above.
-
Deal with the anus first and last. Do the work with
the urethra in the middle as described in the procedure above. This
ordering also eliminates the possibility of urethral damage by the
sound when inserting and removing the anal electrode because the
sound is not present during those steps.
Alcohol wipes are not particularly effective except for
their degreasing and abrading (cleansing) action. They should not be
used in this procedure. Use warm soapy water to do an initial cleansing
of the crotch and anal area.
Benzalkonium chloride is an antiseptic. The packaged
wipes make it very convenient for several purposes because of their
size. It is used here to make a drape around the penis. See
illustrations. It is also used to kill bacteria on the shaft of the
penis. Finally, when laid out on a clean, dry surface they make a
sterile field for the temporary placement of other sterile items. Click
here for information on a particular brand of this antiseptic.
Povidone-iodine slowly releases iodine which acts as antiseptic.
It is effective enough that it is used in surgical situations for both
the staff and the patient. Being bright red, the scrubbed areas clearly
stand out. It is effective as long as the color is present. The wipes
are well saturated with the solution, and it can stain. It also has been
known to effect gold jewelry. Click
here for more information.
Sterile gloves are not required except in clinical
settings and similar circumstances. There is a distinct skill required
in donning these gloves in order to keep the working surface sterile.
Pulling on gloves is hard enough without these additional complications.
In addition, touching the packaging of any sterile item eliminates the
sterility of the gloves. With all that in mind, you might wish to use a Benzalkonium
chloride wipe to cleanse the fingers of the gloves before handling the
sound.
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