Skip to main content

Clinical Neuro-urophysiological Investigations

  • Chapter
  • First Online:
Neuro-Urology
  • 816 Accesses

Abstract

A neuro-urologist’s primary aim is to prevent irreversible renal deterioration. Urodynamic studies remain a key procedure in the risk stratification of patients with neuro-urological complaints; however, there are a number of additional electrodiagnostic investigations available which can add a deeper understanding of lower urinary tract dysfunction. In this chapter, we outline uro-neurophysiological investigations that can be performed in order to better understand patients’ underlying pathology and improve patient management.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

BCR:

Bulbocavernosus reflex

CT:

Computerised tomography

DSD:

Detrusor sphincter dyssynergia

EMG:

Electromyography

MRI:

Magnetic resonance imaging

SEP:

Somatosensory potential

References

  1. Podner S, et al. Lower urinary tract dysfunction in patients with peripheral nervous system lesions. Handb Clin Neurol. 2015;130:203–24.

    Article  Google Scholar 

  2. Homma Y, Batista J, Bauer S, et al. Urodynamics. Incontinence: international consultation on incontinence. Plymouth: Health Publication Ltd.; 2002. p. 317.

    Google Scholar 

  3. Padilla-Fernandez B, Batista J, Bauer S, et al. Urodynamics. Incontinence: international consultation on incontinence. Plymouth: Health Publication Ltd.; 2002. p. 317.

    Google Scholar 

  4. Nordling J, Meyhoff HH. Dissociation of urethral and anal sphincter activity in neurogenic bladder dysfunction. J Urol. 1979;122:352–6.

    Article  CAS  PubMed  Google Scholar 

  5. Palace J, Chandiramani VA, Fowler CJ. Value of sphincter electromyography in the diagnosis of multiple system atrophy. Muscle Nerve. 1997;20:1396–403.

    Article  CAS  PubMed  Google Scholar 

  6. Mahajan ST, Fitzgerald MP, Kenton K, Shott S, Brubaker L. Concentric needle electrodes are superior to perineal surface-patch electrodes for electromyographic documentation of urethral sphincter relaxation during voiding. BJU Int. 2006;97:117–20.

    Article  PubMed  Google Scholar 

  7. Fowler CJ, Kirby RS, Harrison MJ, Milroy EJ, Turner-Warwick R. Individual motor unit analysis in the diagnosis of disorders of urethral sphincter innervation. J Neurol Neurosurg Psychiatry. 1984;47:637–41.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Kavia RB, Datta SN, Dasgupta R, Elneil S, Fowler CJ. Urinary retention in women: its causes and management. BJU Int. 2006;97(2):281–7.

    Article  PubMed  Google Scholar 

  9. Fowler CJ. Investigational techniques. Eur Urol. 1998;34(Suppl 1):10–2.

    Article  PubMed  Google Scholar 

  10. Mundy AR, Borzyskowski M, Saxton HM. Videourodynamics evaluation of neuropathic vesicourethral dysfunction in children. BJU Int. 1982;54:645–9.

    Article  CAS  Google Scholar 

  11. Wenzel BJ, Boggs JW, Gustafson KJ, Creasey GH, Grill WM. Detection of neurogenic detrusor contractions from the activity of the external anal sphincter in cat and human. Neurourol Urodyn. 2006;25:140–7.

    Article  PubMed  Google Scholar 

  12. Hansen J, Borau A, Rodríguez A, Vidal J, Sinkjaer T, Rijkhoff NJ. Urethral sphincter EMG as event detector for neurogenic detrusor overactivity. IEEE Trans Biomed Eng. 2007;54:1212–9.

    Article  PubMed  Google Scholar 

  13. Light JK, Faganel J, Beric A. Detrusor areflexia in suprasacral spinal cord injuries. J Urol. 1985;134:295–7.

    Article  CAS  PubMed  Google Scholar 

  14. La Joie WJ, Cosgrove MD, Jones WG. Electromyographic evaluation of human detrusor muscle activity in relation to abdominal muscle activity. Arch Phys Med Rehabil. 1976;57:382–6.

    PubMed  Google Scholar 

  15. Kinder M, Gommer E, Janknegt R, van Waalwijk van Doorn E. Recording the detrusor electromyogram is still a difficult and controversial enterprise. Neurourol Urodyn. 1998;17:571–3.

    Article  CAS  PubMed  Google Scholar 

  16. Kjolhede P, Lindehammar H. Pelvic floor neuropathy in relation to the outcome of Burch colposuspension. Int Urogynecol J Pelvic Floor Dysfunct. 1997;8:61–5.

    Article  CAS  PubMed  Google Scholar 

  17. Andersen JT, Bradley WE. Abnormalities of bladder innervation in diabetes mellitus. Urology. 1976;7:442–8.

    Article  CAS  PubMed  Google Scholar 

  18. Vereecken RL, De Meirsman J, Puers B, Van Mulders J. Electrophysiological exploration of the sacral conus. J Neurol. 1982;227:135–44.

    Article  CAS  PubMed  Google Scholar 

  19. GLOWM- global library of women medicine. http://www.glowm.com/section_view/heading/Neurophysiologistesting. Accessed 1 Nov 2017.

  20. Di Lazzaro V, Pilato F, Oliviero A, Saturno E, Dileone M, Tonali PA. Role of motor evoked potentials in diagnosis of cauda equina and lumbosacral cord lesions. Neurology. 2004;63:2266–71.

    Article  PubMed  Google Scholar 

  21. Brostrom S. Motor evoked potentials from the pelvic floor. Neurourol Urodyn. 2003;22:620–37.

    Article  PubMed  Google Scholar 

  22. Schmid DM, Curt A, Hauri D, Schurch B. Motor evoked potentials (MEP) and evoked pressure curves (EPC) from the urethral compressive musculature (UCM) by functional magnetic stimulation in healthy volunteers and patients with neurogenic incontinence. Neurourol Urodyn. 2005;24:117–27.

    Article  PubMed  Google Scholar 

  23. Eardley I, Nagendran K, Lecky B, Chapple CR, Kirby RS, Fowler CJ. Neurophysiology of the striated urethral sphincter in multiple sclerosis. Br J Urol. 1991;68:81–8.

    Article  CAS  PubMed  Google Scholar 

  24. Badr G, Carlsson CA, Fall M, Friberg S, Lindström L, Ohlsson B. Cortical evoked potentials following stimulation of the urinary bladder in man. Electroencephalogr Clin Neurophysiol. 1982;54:494–8.

    Article  CAS  PubMed  Google Scholar 

  25. Galloway NT, Chisholm GD, McInnes A. Patterns and significance of the sacral evoked response (the urologist's knee jerk). Br J Urol. 1985;57:145–7.

    Article  CAS  PubMed  Google Scholar 

  26. Curt A, Rodic B, Schurch B, Dietz V. Recovery of bladder function in patients with acute spinal cord injury: significance of ASIA scores and somatosensory evoked potentials. Spinal Cord. 1997;35:368–73.

    Article  CAS  PubMed  Google Scholar 

  27. Fowler CJ, Benson JT, Craggs MD, et al. Clinical neurophysiology in 2nd international consultation on incontinence. Plymouth: Health Publication Ltd.; 2002. p. 391–424.

    Google Scholar 

  28. Kaiho Y, Namima T, Uchi K, Nakagawa H, Aizawa M, Orikasa S. Electromyographic study of the striated urethral sphincter by using the bulbocavernosus reflex: study of the normal voluntary voiding and the involuntary sphincter relaxation. Nippon Hinyokika Gakkai Zasshi. 1999;90:893–900.

    PubMed  CAS  Google Scholar 

  29. Kaiho Y, Namima T, Uchi K, et al. Electromyographic study of the striated urethral sphincter by using the bulbocavernosus reflex: study of the normal voluntary voiding and the involuntary sphincter relaxation. Nippon Hinyokika Gakkai Zasshi. 2000;91:715–22.

    PubMed  CAS  Google Scholar 

  30. Niu X, Shao B, Ni P, Wang X, Chen X, Zhu B, Wang Z, Teng H, Jin K. Bulbocavernosus reflex and pudendal nerve somatosensory-evoked potentials responses in female patients with nerve system diseases. J Clin Neurophysiol. 2010;27:207–11.

    Article  PubMed  Google Scholar 

  31. Niu X, Wang X, Ni P, Huang H, Zhang Y, Lin Y, Chen X, Teng H, Shao B. Bulbocavernosus reflex and pudendal nerve somatosensory evoked potential are valuable for the diagnosis of cauda equina syndrome in male patients. Int J Clin Exp Med. 2015;8:1162.

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Ecclestone, H., Hamid, R. (2018). Clinical Neuro-urophysiological Investigations. In: Dmochowski, R., Heesakkers, J. (eds) Neuro-Urology. Springer, Cham. https://doi.org/10.1007/978-3-319-90997-4_13

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-90997-4_13

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-90995-0

  • Online ISBN: 978-3-319-90997-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics