Abstract
Electrodiagnostic testing of the pelvic floor is becoming increasingly common in clinical pelvic medicine and pelvic floor research. Clinically, it can be used with history, physical examination, and urodynamic testing to aid in the diagnosis of certain pelvic floor disorders and to determine if a central or peripheral neurologic problems exists. Electrodiagnostic testing is also emerging in studies investigating the etiology of pelvic floor disorders. A basic understanding of the principles and techniques used in electrodiagnostic medicine is essential for reconstructive pelvic surgeons. However, most pelvic surgeons will never have the skills or expertise to perform pelvic floor neurophysiologic testing. Multidisciplinary teams including urogynecologic, urologic, and colorectal surgeons, physiatrists, neurologists, and physical therapists are imperative if we are going to improve our understanding of pelvic floor disorders and improve treatment outcomes.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Kiff ES, Swash M. Slowed conduction in the pudendal nerves in idiopathic (neurogenic) faecal incontinence. Br J Surg 1984;71:614–616.
Snooks SJ, Swash M, Mathers SE, Henry MM. Effect of vaginal delivery on the pelvic floor: A 5-year follow-up. Br J Surg 1990;77:1358–1360.
Snooks SJ, Swash M, Henry MM, Setchell M. Risk factors in childbirth causing damage to the pelvic floor innervation. Int J Colorectal Dis 1986;1:20–24.
Snooks SJ, Badenoch DF, Tiptaft RC, Swash M. Perineal nerve damage in genuine stress urinary incontinence. An electrophysiological study. Br J Urol 1985;57:422–426.
Snooks SJ, Henry MM, Swash M. Faecal incontinence due to external anal sphincter division in childbirth is associated with damage to the innervation of the pelvic floor musculature: A double pathology. Br J Obstet Gynaecol 1985; 92:824–828.
Snooks SJ. Risk factors in childbirth causing damage to the pelvic floor innervation. Br J Surg 1985;72(suppl):S15–17.
Snooks SJ, Barnes PR, Swash M. Damage to the innervation of the voluntary anal and periurethral sphincter musculature in incontinence: an electrophysiological study. J Neurol Neurosurg Psychiatry 1984;47:1269–1273.
Snooks SJ, Swash M. Abnormalities of the innervation of the urethral striated sphincter musculature in incontinence. Br J Urol 1984;56:401–405.
Olsen AL, Ross M, Stansfield RB, Kreiter C. Pelvic floor nerve conduction studies: Establishing clinically relevant normative data. Am J Obstet Gynecol 2003;189:1114–1119.
Mahajan ST, Fitzgerald MP, Kenton K et al. Concentric needle electrodes are superior to perineal surface-patch electrodes for electromyographic documentation of urethral sphincter relaxation during voiding. BJU Int 2006;97:117–120.
Podnar S, Vodusek DB. Standardization of anal sphincter electromyography: Utility of motor unit potential parameters. Muscle Nerve 2001;24:946–951.
Enck P, Franz H, Azpiroz F et al. Innervation zones of the external anal sphincter in healthy male and female subjects. Preliminary results. Digestion 2004;69:123–130.
Merletti R, Bottin A, Cescon C et al. Multichannel surface EMG for the non-invasive assessment of the anal sphincter muscle. Digestion 2004;69:112–122.
Oelrich TM. The striated urogenital sphincter muscle in the female. Anat Rec 1983;205:223–232.
Junemann KP, Schmidt RA, Melchior H, Tanagho EA. Neuroanatomy and clinical significance of the external urethral sphincter. Urol Int 1987;42:132–136.
Barber MD, Bremer RE, Thor KB et al. Innervation of the female levator ani muscles. Am J Obstet Gynecol 2002;187:64–71.
Snooks SJ, Barnes PR, Swash M. Damage to the innervation of the voluntary anal and periurethral sphincter musculature in incontinence: an electrophysiological study. J Neurol Neurosurg Psychiatry 1984;47:1269–1273.
Snooks SJ, Swash M, Henry MM. Abnormalities in central and peripheral nerve conduction in patients with anorectal incontinence. J R Soc Med 1985;78:294–300.
Snooks SJ, Barnes PR, Swash M, Henry MM. Damage to the innervation of the pelvic floor musculature in chronic constipation. Gastroenterology 1985;89:977–981.
Gilliland R, Altomare DF, Moreira H Jr et al. Pudendal neuropathy is predictive of failure following anterior overlapping sphincteroplasty. Dis Colon Rectum 1998;41:1516–1522.
Sangwan YP, Coller JA, Barrett RC et al. Unilateral pudendal neuropathy. Impact on outcome of anal sphincter repair. Dis Colon Rectum 1996;39:686–689.
Chen AS, Luchtefeld MA, Senagore AJ et al. Pudendal nerve latency. Does it predict outcome of anal sphincter repair? Dis Colon Rectum 1998;41:1005–1009.
Gregory WT, Lou JS, Stuyvesant A, Clark AL. Quantitative electromyography of the anal sphincter after uncomplicated vaginal delivery. Obstet Gynecol 2004;104:327–335.
Kondo Y, Homma Y, Takahashi S et al. Transvaginal ultrasound of urethral sphincter at the mid urethra in continent and incontinent women. J Urol 2001;165:149–152.
Heit M. Intraurethral sonography and the test-retest reliability of urethral sphincter measurements in women. J Clin Ultrasound 2002;30:349–355.
Kenton K, FitzGerald MP, Shott S, Brubaker L. Role of urethral electromyography in predicting outcome of burch retropubic urethropexy. Am J Obstet Gynecol 2001; 185:51–55.
Fischer JR, Hale DS, McClellan E, Benson JT. The use of urethral electrodiagnosis to select the method of surgery in women with instrinsic sphincter deficiency. Int Urogynecol J 2001;12(suppl 1):51.
Zivkovic F, Tamussino K, Ralph G et al. Long-term effects of vaginal dissection on the innervation of the striated urethral sphincter. Obstet Gynecol 1996;87:257–260.
Benson JT, McClellan E. The effect of vaginal dissection on the pudendal nerve. Obstet Gynecol 1993;82:387–389.
Benson JT, Lucente V, McClellan E. Vaginal versus abdominal reconstructive surgery for the treatment of pelvic support defects: A prospective randomized study with longterm outcome evaluation. Am J Obstet Gynecol 1996; 175:1418–1421; discussion 1421-1422.
Maher CF, Qatawneh AM, Dwyer PL et al. Abdominal sacral colpopexy or vaginal sacrospinous colpopexy for vaginal vault prolapse: A prospective randomized study. Am J Obstet Gynecol 2004;190:20–26.
Fynes M, Donnelly VS, O’Connell PR, O’Herlihy C. Cesarean delivery and anal sphincter injury. Obstet Gynecol 1998;92:496–500.
Podnar S, Lukanovic A, Vodusek DB. Anal sphincter electromyography after vaginal delivery: Neuropathic insufficiency or normal wear and tear? Neurourol Urodyn 2000;19:249–257.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2010 Springer-Verlag Italia
About this chapter
Cite this chapter
Gregory, W.T., Kenton, K. (2010). Clinical Neurophysiology of the Pelvic Floor. In: Santoro, G.A., Wieczorek, A.P., Bartram, C.I. (eds) Pelvic Floor Disorders. Springer, Milano. https://doi.org/10.1007/978-88-470-1542-5_5
Download citation
DOI: https://doi.org/10.1007/978-88-470-1542-5_5
Publisher Name: Springer, Milano
Print ISBN: 978-88-470-1541-8
Online ISBN: 978-88-470-1542-5
eBook Packages: MedicineMedicine (R0)