Computer-assisted interpretation of electromyograms of corpora cavernosa using fuzzy logic

Abstract

An electromyogram of the corpora cavernosa (CC-EMG) imparts information on the autonomic cavernous innervation and/or the cavernous smooth muscles. The CC-EMG is interpreted mainly by evaluation of signal patterns of higher activity. The time required for interpretation is reduced by the implementation of a computer-assisted diagnosis program with a Microsoft Windows user interface. The program offers four levels of diagnosis: on the first level, recordings can be edited; on the second and third levels, signal patterns can be searched or evaluated; and on the last level the final diagnosis is provided. The computer-assisted interpretation is based on digital measurement data. These data have been obtained through a 170.6-Hz sampling frequency and a quantization of 10 V/12 Bit of the amplified signal. The first task of this diagnosis program is to discover and extract signal patterns of higher activity from data stored on the hard disk of a personal computer (PC). For a mathematic description of these patterns the following features were defined: relative time position, relative reproducibility, part of normal phases, and part of whip phases. Syntactic pattern recognition was introduced to identify the characteristic signal forms. An evaluation of the patterns could be derived from these features using fuzzy logic. For a summary of the evaluated patterns the variable global normality was established. The global normality forms an important evaluation basis along with the global synchronism, which represents an investigator's first impression of a recording. The final diagnosis is completed using fuzzy logic. The program was tested by comparison of expert and computer diagnoses. A total of 30 records were independently evaluated by an expert team and the computer program. With reference to the four classified levels of diagnosis a correspondence of 70% could be found. Furthermore, the rate in each of the classified levels was higher than 50%. The discrimination between normal and abnormal evaluation was 80% for clinical routine. Our results show that a computer-assisted interpretation of the CC-EMG can be achieved using mathematically based software. Within the last 7 months this computer-assisted CC-EMG program proved to be of great help in routine diagnosis. Furthermore, it demonstrated results comparable with a blinded-expert interpretation. This approach should bring about dramatic improvements in the diagnosis of erectile dysfunction.

Erectile dysfunction in relation to traumatic pelvic injuries or pelvic fractures

“…All patients in our impotence clinic undergo a comprehensive evaluation of the aetiology of their ED, which includes a case history, physical examination, routine blood laboratory tests (including testosterone assay), sexual case history (by a psychiatrist [13]), corpus cavernosum‐EMG (CC‐EMG, [14,15]), standardized pharmacological testing [16] and colour‐coded duplex ultrasonography (US) [17,18] of the penile arteries.…”

Leitlinie zur Diagnostik und Therapie von Libido- und Erektionsstörungen

“…trierung der kavernösen elektrischen Aktivität [23,24]. Normalerweise lässt diese im flakziden Zustand bestimmte Muster erkennen: Phasen ausgeprägter elektrischer Aktivität, sog.…”

Usefulness of electromyography of the cavernous corpora (CC EMG) in the diagnosis of arterial erectile dysfunction

“…To overcome these inconveniences, algorithms based on mathematical frequency analyses have been used, resolving the spectrum based on the Fourier function 14 or the application of fuzzy logic. 15 All this has greatly complicated the technique, thus explaining why despite its introduction 420 years ago, the procedure has not yet been transferred from the laboratory setting to routine clinical practice. The present study aimed to evaluate the clinical usefulness of CC-EMG, comparing its results with this and those obtained by the gold standard for the diagnosis of arteriogenic ED (Doppler ultrasound).…”