Neurophysiology of the pelvic floor in clinical practice: a systematic literature review

Bianchi, Francesca; Squintani, Giovanna; Osio, Maurizio; Morini, Arianna Lodovica; Bana, Cristina; Ardolino, Gianluca; Barbieri, S.; Bertolasi, Laura; Caramelli, R.; Cogiamanian, F.; Currà, Antonio; G, De Scisciolo; Foresti, C.; Frasca,; Frasson, Emma; Inghilleri, Maurizio; Maderna, Luca; Motti, L.; Onesti, Emanuela; Mc, Romano; U, Del Carro

doi:10.11138/fneur/2017.32.4.173

Cited by 21 publications

(13 citation statements)

References 84 publications

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“…120 This assessment as a rule focuses on the motor units to investigate motor unit physiology and pathophysiology. Parameters evaluated with concentric needle EMG can be used to differentiate between normal, denervated, reinnervated and myopathic muscle 121,122 Quantitative EMG includes analysis such as the multi-motor unit potential analysis 122 and the interference pattern analysis (turns/zero crossing or amplitude). 122 3.4.2 Surface electromyography (sEMG): Is a recording of motor unit action potentials using surface electrodes placed on the skin or mucosa close to the muscle of interest.…”

Section: Vector Manometrymentioning

confidence: 99%

“…Parameters evaluated with concentric needle EMG can be used to differentiate between normal, denervated, reinnervated and myopathic muscle 121,122 Quantitative EMG includes analysis such as the multi-motor unit potential analysis 122 and the interference pattern analysis (turns/zero crossing or amplitude). 122 3.4.2 Surface electromyography (sEMG): Is a recording of motor unit action potentials using surface electrodes placed on the skin or mucosa close to the muscle of interest. Recordings are also used in assessment of the activation pattern/"behavior" (sometimes referred to as kinesiological electromyography) of a particular muscle during a defined activity.…”

Section: Vector Manometrymentioning

confidence: 99%

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An International Continence Society (ICS) report on the terminology for pelvic floor muscle assessment

Frawley

Shelly

Morin

et al. 2021

Neurourology and Urodynamics

138

118

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Introduction The terminology for female and male pelvic floor muscle (PFM) assessment has expanded considerably since the first PFM function and dysfunction standardization of terminology document in 2005. New terms have entered assessment reports, and new investigations to measure PFM function and dysfunction have been developed. An update of this terminology was required to comprehensively document the terms and their definitions, and to describe the assessment method and interpretation of the finding, to standardize assessment procedures and aid diagnostic decision making. Methods This report combines the input of members of the Standardisation Committee of the International Continence Society (ICS) Working Group 16, with contributions from recognized experts in the field and external referees. A logical, sequential, clinically directed assessment framework was created against which the assessment process was mapped. Within categories and subclassifications, each term was assigned a numeric coding. A transparent process of 12 rounds of full working group and external review was undertaken to exhaustively examine each definition, plus additional extensive internal development, with decision making by collective opinion (consensus). Results A Terminology Report for the symptoms, signs, investigations, and diagnoses associated with PFM function and dysfunction, encompassing 185 separate definitions/descriptors, has been developed. It is clinically based with the most common assessment processes defined. Clarity and user‐friendliness have been key aims to make it interpretable by clinicians and researchers of different disciplines. Conclusion A consensus‐based Terminology Report for assessment of PFM function and dysfunction has been produced to aid clinical practice and be a stimulus for research.

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Section: Vector Manometrymentioning

confidence: 99%

Section: Vector Manometrymentioning

confidence: 99%

An International Continence Society (ICS) report on the terminology for pelvic floor muscle assessment

Frawley

Shelly

Morin

et al. 2021

Neurourology and Urodynamics

138

118

View full text Add to dashboard Cite

show abstract

“…Most studies assumed a “neurogenic” origin of the symptoms on the basis of neurophysiological results, without any established independent criteria supporting the diagnosis of neuropathy. We just found a systematic review gathering available evidence about the utility of neurophysiological tests in pelvic floor disorders …”

Section: Discussionmentioning

confidence: 99%

Neurophysiologic study in idiopathic overactive bladder

Ali

Gadallah

Zohiery

et al. 2018

Neurourology and Urodynamics

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Aim: Idiopathic overactive bladder (OAB) is a prevalent, mystifying disorder with a questionable neurogenic background. We aimed to investigate the possible subtle neuropathic affection underlying its pathogenesis. Methods: A cross-sectional cut off study was carried out on a series of 38 females with idiopathic OAB and 22 healthy matched female volunteers. The following was performed: symptom score questionnaire, determination of pudendal nerve terminal motor latency (PNTML), sacral reflexes' latencies, pudendal somatosensory evoked potentials, and needle electromyography of the external anal and urethral sphincters. Results: A highly significant prolongation of PNTMLs and sacral reflexes latencies among the patients group was detected (P ≥ 0.001). Pudendal somatosensory evoked potentials showed non-significance among the two studied groups (P ≥ 0.05).External anal sphincter neuropathic affection was detected in 27 patients (71%) and external urethral sphincter neuropathic affection was detected in 30 patients (78.9%). The clitoral anal reflex showed the highest sensitivity and specificity among the neurophysiologic tests used in assessing the neuropathic affection (86.7 and 83%, respectively), followed by PNTML (83.3 and 80%, respectively). Conclusion: Pudendal neuropathy is the dominating possible attributing factor in the pathogenesis underlying idiopathic OAB. An integrated clinical, urodynamic, and electro-physiological assessment is recommended for evaluation of any overactive bladder patients. K E Y W O R D S detrusor overactivity, pelvic floor electromyography, pudendal nerve terminal motor latency, sacral reflexes

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“…It is essential for diagnosis of patients with neurological disorders as central lesion (i.e., upper motor neuron lesion) and cauda equine lesions. However, patients with obvious neurological disorders were excluded from the study [55,56]. (iii) BC reflex was not assessed.…”

Section: Limitations Of the Workmentioning

confidence: 99%

Relation between pelvic floor neurophysiological abnormalities and erectile dysfunction in patients with obstructed defecation

Elsawy

Saba

2021

Afr J Urol

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Background Obstructed defecation is a common pelvic floor medical problem among adult population. Pelvic floor disorders were reported to be associated with sexual dysfunction including erectile dysfunction among male patients. The aim was to determine the relation between pelvic floor neurophysiological abnormalities and erectile dysfunction in male patients with obstructed defecation. Methods This cross-sectional study included 65 married male patients with obstructed defecation and a control group consisted of 15 apparently healthy married males. Assessment of obstructed defecation severity was done by using modified obstructed defecation score, time of toileting and Patient Assessment of Constipation-Quality of Life questionnaire. Assessment of erectile functions was done using erectile function domain of International Index of Erectile Function questionnaire and Erectile Dysfunction-Effect on Quality of Life Questionnaire. Anal manometry and dynamic pelvis magnetic resonance imaging were done. Electrophysiological studies included pudendal nerve motor conduction study and needle electromyography of external anal sphincter, puborectalis and bulbocavernosus muscles. Results There were 32 patients (49.2%) who had erectile dysfunction. The maximum straining anal pressure was significantly higher among patients with erectile dysfunction. Pudendal nerve terminal motor latency was significantly delayed and the percentage of bilateral pudendal neuropathy was significantly higher among patients with erectile dysfunction. The percentage of electromyography evidence of denervation with chronic reinnervation in the external anal sphincter and bulbocavernosus muscles were significantly higher among patients with erectile dysfunction. Regression analysis detected three co-variables to be associated with significantly increasing the likelihood of development of erectile dysfunction. These were maximum straining anal pressure (odd ratio = 1.122), right pudendal nerve terminal motor latency (odd ratio = 3.755) and left pudendal nerve terminal motor latency (odd ratio = 3.770). Conclusions Erectile dysfunction is prevalent among patients with obstructed defecation. It is associated with characteristic pelvic floor electrophysiological abnormalities. Pelvic floor neurophysiological changes vary from minimal to severe neuromuscular abnormalities that usually accompanying erectile dysfunction. Pudendal neuropathy and increased maximum straining anal pressure are essential risk factors for increasing the likelihood of development of erectile dysfunction in patients with obstructed defecation.

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Neurophysiology of the pelvic floor in clinical practice: a systematic literature review

Cited by 21 publications

References 84 publications

An International Continence Society (ICS) report on the terminology for pelvic floor muscle assessment

An International Continence Society (ICS) report on the terminology for pelvic floor muscle assessment

Neurophysiologic study in idiopathic overactive bladder

Relation between pelvic floor neurophysiological abnormalities and erectile dysfunction in patients with obstructed defecation

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