Using the ultrasound for therapeutic heat in PE

Sorry, dude, I guess here we have a translation issue. I really don’t get your question.

After 6 months of using FIR pad/vac hanging using 5.5^2 protocol with good results, I have recently purchased a 1/3 Hz US.

I have read plenty of information in several threads and thought I was prepared.
However, it seems I wasn’t.
Yesterday I unpacked the device ( Ultrasonido portátil sonovit con cabezal cilíndrico. 30 programas predeterminados - Tienda fisaude )

And I didn’t notice any heat in my unit.

I didn’t really feel anything but I very very mild warm sensation, and just when I put a lot of gel.
Is this normal?
I thought that by using US I would feel the heat in my unit similar to a pad. I didn’t feel almost anything. I was, and I am very puzzled.
The setup I used was based on the threads I´ve studied (3Hz /1,5 intensity /continuous)
That is my first question.

My second doubt is:
I understand that for a 3Hz usage, a phantom is not needed, but,,,, what is a phantom? I promise that before asking I searched in TP and google with thousands of mentions, but still I don’t know what it looks like.

Sorry for my super naive questions folks.

@Alexiogerio
Check this post from @Rocco25.
US Phantom made of silicone

Phantom acts as a buffer to absorb the US soundwaves. If there is no phantom, the US soundwaves can reflect back into the shaft and can cause the following interference effect: Dampen the original soundwave, reducing its power, OR amplify the original soundwave, causing high power density which can be painful.

And regarding not feeling any heat while using US. You will most probably not feel anything, until you reach temperature above 39C-40C. And this can take some time - more than 10 minutes.

Nshaq, thanks, it’s a relief, I thought the device was not working.

If you could suggest the perfect newbie setup for my US device I would very much appreciate it.

For what I read I believe it could be 3Hz, 1,5intensity, continuous.

I’m just checking, as I don’t feel any heat in my first under 10 minute trial I can’t asses.

Thanks again nshaq

@alexiogerio, i am afraid there is no such thing as a newbie setup when it comes to using US devices for PE. This is an advanced method from the start. There are a lot of components to this method that need to work together well, in order to get results. I am not sure what are your experiences in PE, but you should be able to understand and perform the following:

-Vap cups and glans protection
-Hanging vs. extending
-Stress relaxation vs. creep
-Characteristics of Tunica Albuginea (What are 0.10MPa and 0.17MPa loads)
-Over-the-leg vs. US phantom
-Quality of US device (VERY IMPORTANT) and correct settings
-Safety precations of using US for heating (EXTREMELY IMPORTANT)
-Monitoring the temperature with a suitable thermometer

One session of using the US device usually goes as follows:
-30 minutes creep or stress relaxation
-20 minutes US heating
-10 minutes cooldown

BTW, you didn’t specify in what conditions you are using US heat, but just to be clear, don’t use US heating on unloaded shaft, cause it can cause contraction of connective tissue.

Thanks Nshaq

I’ve been 8 months vacuum hanging following 5.5 Squared protocol and conditioned to FIR heat pad. 5.5 Squared does an outstanding and simplified interpretation of Kyrpas/Tutt (and others) investigations, and I already read almost all Kyrpas threads on US before purchasing my device. I have elaborated my protocol with a heating pad, increasing the weights slowly, even cooling down, etc. But, again, I followed 5.5 as thoroughly as possible.

Already been in PE in total for 1,5ish years with (I think) positive results (BPEL 16,7>19,80).
So thought I was prepared for US.

Most of the concepts are similar (and precursors) to 5.5 Squared methodologies, and yes, what you kindly described Nshaq is similar to what I am currently doing with FIR.

I hang straight out (total man vacuum cup), and based on one of Tutt’s posts and your advice above, I will try the following setup:
-30 minutes stress relaxation ramping slowly up from 0,5kg to 2kg until I have surpassed my BPEL
-20 minutes US heating. Settings: 3Hz, 1,5intensity, continuous. Increasing load from 2kg to 2,50kg (I doubt the 1,5W/cm intensity, but I’ve read that we shouldn’t go over 2.) Is 1,5 W/cm appropriate to start off?
-10 minutes cool down, increasing weight from 2,50kg to 3 kg.

Hanging position straight out, using my Total Man heat pad as a phantom (I don’t really know if this has sense, but I believe Tutt was happy doing that )
I don’t have a proper thermometer; if you think it is essential and I shouldn’t start without it, please advise, and I will try to obtain one.

I will start my own thread where I will copy some of you veterans’ quotes, “US for Dummies”

Thanks again, Nshaq and the rest of the brotherhood.

If I’m doing something wrong, I would appreciate your observations.

A heat pad cannot act as a phantom. Therefore, I do not believe that Tutt did this.
A phantom is designed to transmit the ultrasound waves without interference so that they do not reflect off the surface of the skin and form a standing wave.

Here is the background knowledge on this:
Heating problems with extender users

If you don’t have a phantom, then you have to use your leg. But since I didn’t want to do OTL and I also didn’t want to work with an ultrasonic pad that only holds a few units, I went in search of a suitable material and came out with DragonSkin. It has similar impedance properties as human tissue. No matter if Phantom or leg: never save on gel.
Even though I haven’t tried it yet, I would probably use the DragonSkin 10 NV today. The DragonSkin 20 is a bit harder than I thought and forms a lot of bubbles when you mix it, which you remove using a vacuum. Hence the "NV", which stands for no vacuum.
Dragon Skin™ 10 NV Product Information | Smooth-On, Inc.

I have not tested it yet, but the description sounded promising. Has anyone of you guys already tried it?

If I were you, I would not continue without measuring the temperature. I use (as probably some others here) a device like this here:
https://www.ama … /dp/B09YQYJ5QF/

The thermocouples are located between the shaft and the phantom, surrounded by gel.

@Rocco25, I haven’t used the Dragon Skin 10NV yet, but i did use the Dragon Skin 20 and i added 10% of their Silicone Thinner. It makes the DS20 softer and much more flexible. It also lowers viscosity of the Dragon Skin while it is curing, so a lot more air bubble come out and do not stay trapped in the cured phantom. It might also be useful together with 10NV.

Hello. What is the difference in degrees between the urethra and the dorsal side when using an ultrasound?

Thanks Rocco
I have now read by recommendation of Nshaq all your research and manufacture of phantoms, where (I believe) you are leading in the field.
After yesterday’s test (Totalman vacuum hanger plus US), I noticed that the area covered by the silicon sleeve heated more & quicker.
Therefore, I have wondered if we cover all our unit with a silicon sleeve, we might make better use of the US and avoid manipulating the phantom.
Bellow an image of a sleeve that allows hanging. Have you ever tried something similar? or considered wearing a vacuum cup and all shaft covered with a full sleeve (type Totalman sleeves)?
Thanks for the temperature device; l have now taken your and Nashq´s advice and I have purchased the same model.

Hi again Rocco; this is Tutt´s quote & link.
“I will say that I’ve had very good results of very even reliable heat across the majority of the shaft with a combination of Autosound US placed ventrally and heating pad placed dorsally set at 44C. This might be my new favorite combo. Completely hands free.”
Tutt
U.S. vs FIR pad discussion (p. 2)

Yes, when I read it, I was also puzzled. Maybe it´s only applicable for autosound?

@alexiogerio, this is something different at play here. Tutt used heat pad to help speed up and maintain the temperature at therapeutic levels. He didn’t use it as phantom.

Also, regarding the covering of the shaft with silicone sleeve: When you put the US head directly on the shaft, the sound waves penetrate through the skin before they are absorbed as heat, so this is why you don’t feel higher temperature at skin level. When you put silicone sleeve between US head and shaft, it absorbs some of the heat. The increased temperature in the sleeve is directly felt on the skin.

Thanks for the feedback.

I’m not a fan of running the transducer over the Phantom. The skin is more flexible, you can also change the angle relative to the shaft as the skin adjusts (with the phantom you always have to be perpendicular). The skin can be pressed flat, the cylindrical phantom rather less so. To make a long story short, the coupling is better and you have less losses at the transition points (e.g. phantom to socket).

US ventral and phantom dorsal works at 1 Mhz. I have no reason to change this and so it didn’t occur to me to investigate further.

Ok, now I get your point.
Nshaq has finally explained it. The Autosound US can do both 1 Mhz and 3 Mhz. I’m pretty sure Tutt used 3 Mhz, otherwise I assume that would have been an extreme painful act. 3 Mhz doesn’t go as deep as 1 Mhz, you can use that in the case of a penis without a phantom.

Another point for the autosound. It contains 4 separate US heads. Much less movement (if any) is required. In fact I’d be tempted to try to leave it in place with a heat pad opposite similar to the Tutt comment. But disregard anything I say about US since I have no practical experience.