Sphincter electromyography and the penilo‐cavernosus reflex: Are both necessary?

Abstract

The study supports the clinical utility of an electrodiagnostic protocol for assessment of men with suspected peripheral sacral lesions that includes both quantitative anal sphincter EMG and sacral reflex studies.

Predictive value of the penilo‐cavernosus reflex

“…2 It has been, furthermore, demonstrated that both methods complement each other. 3 Although a number of different sacral reflexes can be elicited and measured, the penilo-cavernosus reflex is most reliable clinically, and neurophysiologically.…”

Predictive values of the anal sphincter electromyography

“…1,2 Although, for a clinician interpreting the findings of a diagnostic test the most important information is the predictive values of the test, no such data has been published for this test, yet.…”

“…3 Nevertheless, it has been shown that both methods are complementary. 1 The limitation of the study is that the author performing EMG examinations was not blinded to clinical condition of studied subjects.…”

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

“…Compared with the automated multi-MUP technique, the interference pattern (IP) analysis with the turns/amplitude (T/A) method has lower sensitivity, particularly for detecting neuropathic changes (i.e., sensitivity 29%), and its use is less supported by the evidence (Podnar et al, 2002b). The sensitivity of QEMG analysis is markedly increased, to 94-96%, when the technique is combined with evaluation of sacral reflexes (Podnar, 2008a) (Table Vs). Data regarding the relevance of EMG to detect axonal damage due to anterograde trans-synaptic degeneration in patients with suprasacral spinal cord injury (SCI) are insufficient to draw any conclusions (Grade D).…”

“…There are no significant differences in the sensitivity of the BCR between mechanical and electrical stimulation in men (Grade B), whereas electrical stimulation has been demonstrated to be more sensitive than mechanical stimulation in women (Podnar, 2014) (Grade C). The combined use of CNEMG and BCR increases the sensitivity of single neurophysiological tests in men (from 81-83% with single/double electrical stimulation of the BCR to 94-96% with CNEMG+BCR testing) (Podnar, 2008a) and in women (from 92-96% to 96-100%) (Podnar, 2014) (Grade B). The pudendal-urethral reflex (PUR) elicited by single electrical or mechanical stimulation may be altered in conus and cauda equina lesions (Grade C).…”