Measuring Urinary Sensation with Current Perception Threshold: A Comparison between Method of Limits and Method of Levels

Abstract

Purpose. To determine the association between the two methods of obtaining current perception thresholds (CPTs) in the lower urinary tract (LUT). Materials and Methods. Twenty-one women undergoing pelvic surgery underwent CPT determinations of the urethra. CPTs were measured at 2,000, 250, and 5 Hz (corresponding to A-β, A-δ, and C fibers, resp.) both pre- and postoperatively. Threshold values were obtained in all patients by using the method of limits and the method of levels. Results. CPT values obtained by using the method of levels and the methods of limits were highly correlated at all frequencies before and after surgery (ρ = 0.93–0.99, P < 0.0001). The mean threshold values obtained by the method of levels were significantly lower at all frequencies compared with those obtained by the method of limits. Conclusions. Our findings suggest that the method of levels is more sensitive for the detection of CPTs compared to the method of limits.

Lower urinary tract electrical sensory assessment: a systematic review and meta‐analysis

“…For CPT detection, two stimulation algorithms were used: method of limits (70.4%) and method of levels [91]. Although the methods of limits was more timesaving [47], it led to significantly higher CPT values [47]. The latter finding was supported by our current meta‐analysis.…”

“…Out of 80 studies, 61 exclusively applied CPTs [6,7,13–71], but four reported incomplete or no CPT results [14,32,61,64] (Table S2).…”

“…Thirteen studies compared LUTCPTs of pelvic surgery patients to (preoperative) controls. Most studies reported decreased LUT sensitivity after pelvic surgery [24,30,47,48,49,50,51,82], however, some studies indicated location‐specific differences [7,20,52,53].…”

“…To assess LUTCPTs, two main stimulation algorithms were applied: the ‘method of limits’ and the ‘method of levels’. The shorter investigation time but higher CPTs using the method of limits [47] has to be regarded with caution, since the method of limits was mainly performed manually, whereas the method of levels was applied semi‐automatically. Hence, the type of applied stimulation algorithm may be less relevant compared to the execution, whereas semi‐automated application seems to be more accurate as the investigator‐related bias is excluded.…”

The Current Perception Threshold Test Differentiates Categories of Mechanical Neck Disorder

“…However, the CPT method has been used to evaluate peripheral sensory dysfunction 28 been successfully applied in many clinical studies. 12,29,30,42,43,47,54 Despite emerging literature about the usefulness of CPT, there are limitations. For example, hyperesthetic, normative, and hypoesthetic values of rapid CPT are not yet well established, and the test threshold values can vary according to the location of the test.…”