ICS Educational Module: Electromyography in the assessment and therapy of lower urinary tract dysfunction in adults

Abstract

Aim: To present the teaching module "Electromyography in the assessment and therapy of lower urinary tract dysfunction in adults." This teaching module embodies a presentation, in combination with this manuscript. This manuscript serves as a scientific background review; the evidence base made available on ICS website to summarize current knowledge and recommendations. Methods: This review has been prepared by a Working Group of The ICS Urodynamics Committee. The methodology used included comprehensive literature review, consensus formation by the members of the Working Group, and review by members of the ICS Urodynamics Committee core panel. Results: Electromyography (EMG) is a method to record spontaneous or artificially induced electrical activity of the nerve-muscle unit or to test nerve conductivity. EMG of the anal sphincter using surface electrode is most widely used screening technique to detect detrusor-sphincter dyssynergia in urology. It is non-invasive and easy to perform.EMG methods using needle electrodes are reserved for diagnostics in well selected group of mainly neurogenic patients. These methods require expertise in the field of general EMG and are usually performed by neurologist and neuro-physiologist. The evidence in many aspects of use of EMG in urology remains sparse. Conclusions: Currently EMG methods rarely play a decision making role in selecting proper treatment of lower urinary tract dysfunction. With the current efforts to improve phenotyping of these patients in order to provide individualized treatment, the role of EMG could increase.

The effects of pelvic floor muscle therapy on symptoms, voiding, and pelvic floor muscle activity parameters in children with overactive bladder

“…EMG is the common way to examine and to get information on the problems of any muscles. Nowadays, ICS has recommended EMG before the decision making of type of treatment in patients with lower urinary tract problems . EMG can be performed during voiding or filling phase of lower urinary tract.…”

“…All sEMG recordings were performed by the same physiotherapist and under standard testing conditions. Only tonic PFMs were evaluated during measurement . The electromyographic signal was registered by a dual‐channel sEMG NeuroTrac myoplus 4 device integrated with computer software for digital analysis and report creation.…”

“…Only tonic PFMs were evaluated during measurement. 21 The electromyographic signal was registered by a dual-channel sEMG NeuroTrac myoplus 4 device integrated with F I G U R E 1 Pelvic floor muscle activity (PFMA) of a normal child were seen. During the measurement of PFMA, a normal child must contact and relax his/her PFMs above and below the interrupted line.…”

“…According to International Continence Society (ICS), electromyography (EMG) should be performed before the treatment of LUTD and the evaluation of PFMs can be made with different noninvasive methods. 21 Uroflowmetry combined with perineal electromyography (UF-EMG) is one of them, which shows pelvic floor status during voiding. Another noninvasive way of functional evaluation of PFMs is the measurement of pelvic floor muscle activity (PFMA) after voiding when the PFMs are at the rest period.…”

Urodynamic Effect of Percutaneous Posterior Tibial Nerve Stimulation for Urinary Incontinence in Paraparetic Patients

“…For the detrusor EMG recording, electrodes are placed in an array in front of the pubic bone on the lower abdomen. The common electrode can be placed on the thigh or trochanter [19]. Group (II) T P *SD: standard deviation, P: probability, NS: non-significant.…”