The Electrical Activity of the Paraurethral and Perineal Muscles in Normal and Pathological Conditions

Vereecken, R.L.; Verduyn, H

doi:10.1111/j.1464-410x.1970.tb04483.x

Cited by 104 publications

(38 citation statements)

References 14 publications

(12 reference statements)

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“…These problems become less significant with increasing severity of neuro pathology, so that while with incomplete lesions a random-EMG of the pelvic floor is sufficient to document the activity of the external sphincter, in incomplete lesions of any aetiology a separate evaluation of the peri urethral striated EMG and anal sphincter EMG is advisable (Vereecken and Verduyn, 1970;Perkash, 1980). Uroflowometry and pressure profiles (Sunder et al, 1978;Clarke and Thomas, 1981), as single investigations are useful to understand the underlying pathophysiology but are of limited diagnostic clinical value for paraplegics.…”

Section: Discussionmentioning

confidence: 99%

Urodynamic practice in neuro-urological patients: techniques and clinical value

Madersbacher

Dietl

1984

Spinal Cord

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Summary. During the last decade a variety of urodynamic techniques have been developed.Despite this there is a tendency to be somewhat inflexible in the application of urodynamics; as soon as the investigator becomes familiar with one method he tends to use it for all his urodynamic evaluations.A short survey gives information about the most popular urodynamic methods with their combinations, as well as their clinical value for paraplegics. The type and number of urodynamic techniques used at the Rehabilitation Centre BadHaring during the last 6 years demonstrate that extensive facilities are desirable.This gives the flexibility to choose the proper technique, giving maximal informa tion for the individual patient with minimal costs.The combination of cystometry with X-ray videography (the simplest form of videourodynamics), is the most frequent method used, whereas the time consuming combined pressure-flow-EMG-X-ray-video-studies are only used for special indications (approximately 10 per cent of all our urodynamic studies).In order to obtain information of clinical value sometimes a compromise is necessary in order to find the method somewhere between what we would like to measure and the disturbance caused to the patient.

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Section: Discussionmentioning

confidence: 99%

Urodynamic practice in neuro-urological patients: techniques and clinical value

Madersbacher

Dietl

1984

Spinal Cord

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“…Authors of several studies have speculated that a dysfunction of the posterior urethra at the end of micturition could cause PMD [10]. Feneley [11] and Vereecken and Verduyn [12] postulate a failure of the bulbospongiosus muscle or pelvic floor, its insufficiency causing the impossibility to generate higher intracavernous pressure, a failure of ejaculation force [13], and the loss of the postvoid milking reflex. They state that this results in an inadequate drainage of urine, which has pooled and become trapped in the bulbar urethra after voiding [14].…”

Section: Discussionmentioning

confidence: 99%

Postmicturition Dribble: A Physiological Phenomenon?

Bretterbauer¹,

Heidler²,

Colleselli

et al. 2019

Urol Int

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Background: Postmicturition dribble (PMD) is a common condition in the male population. Objectives: Despite its common occurrence, there are only a few studies on this topic so far. The aim of this study was to investigate possible physiological aspects of PMD. Method: Seventeen men complaining of PMD and 10 healthy subjects were assessed via uroflometry, IPSS questionnaire, IIEF-5 questionnaire, and an adapted visual analogue scale (VAS) for ejaculation force (0–10) and the amount of bother concerning PMD (0–10) were completed. In addition to that, a retrograde urethrography at 40 and 60 cm water column as pressure unit to measure the width of the bulbar urethra was performed, and the amount of PMD was measured with an adjusted pad test. Results: The PMD group showed a significantly worse IPSS score, a lower Qmax rate in uroflowmetry, a worse IIEF-5 score, and a worse VAS score concerning ejaculation force. In both groups, worse IPSS levels correlated with a low bulbar urethral diameter at 40 and 60 cm water column. Another correlation was found between a high maximum urine flow rate and a larger bulbar urethral diameter at 40 and 60 cm. Both groups showed urine loss after micturition, with no bother (VAS 0) in the control group, whereas the PMD group showed a VAS of 6. Conclusions: PMD should be regarded as a physiological occurrence in men rather than a disease by itself. Suffering is only to be expected in combination with other lower urinary tract symptoms.

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“…It is interesting that inserting examining fingers in anus for anal stretch caused marked inhibition of the electromyogram (EMG) activity in both EUS and EAS (48). In ablebodied persons, EMG recording from the EUS and EAS during micturition and cystometry also showed simultaneous electric activity in these muscles (1,50,62). Results coming from clinical studies suggested anal stretch could be a useful technique to facilitate voiding in overactive urethra sphincter patients (15,36,38).…”

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confidence: 99%

Acute anal stretch inhibits NMDA-dependent pelvic-urethra reflex potentiation via spinal GABAergic inhibition in anesthetized rats

Chen

Huang

Kao

et al. 2008

American Journal of Physiology-Renal Physiology

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The impact of acute anal stretch on the pelvic-urethra reflex potentiation was examined in urethane-anesthetized rats by recording the external urethra sphincter electromyogram activity evoked by the pelvic afferent stimulation. Test stimulation (1 stimulation/30 s) evoked a baseline reflex activity with a single action potential that was abolished by gallamine (5 mg/kg iv). On the other hand, the repetitive stimulation (1 stimulation/1 s) induced spinal reflex potentiation (SRP) that was attenuated by intrathecal 6-cyano-7-nitroquinoxaline-2,4-dione (a glutamatergic ␣-amino-3-hydroxy-5-methyl-4-isoxazoleproprionat receptor antagonist, 100 M, 10 l) and D-2-amino-5-phosphonovalerate [a glutamatergic N-methyl-D-aspartate (NMDA) antagonist, 100 M, 10 l]. Acute anal stretch using a mosquito clamp with a distance of 4 mm exhibited no effect, whereas distances of 8 mm attenuated and 12 mm abolished the repetitive stimulation-induced SRP. Intrathecal NMDA (100 M, 10 l) reversed the abolition on SRP caused by anal stretch. On the other hand, pretreated bicuculline [␥-aminobutyric acid (GABA) A receptor antagonist, 100 M, 10 l] but not hydroxysaclofen (GABA B receptor antagonist) counteracted the abolition on the repetitive stimulation-induced SRP caused by the anal stretch. All of the results suggested that anal stretch may be used as an adjunct to assist voiding dysfunction in patients with overactive urethra sphincter and that GABAergic neurotransmission is important in the neural mechanisms underlying external urethra sphincter activity inhibited by anal stretch. spinal cord; voiding dysfunction; glutamate; bicuculline; hydroxysaclofen THE MECHANISM INVOLVED IN micturition, which is the result of coordination between bladder detrusor and outlet, is intricate. Both elements, the detrusor and outlet, maintain a sound cycle of storage and evacuation that is controlled by a group of reflex and voluntary actions (54). During the storage phase of a micturition cycle, detrusor relaxes and urethra contracts to produce continence; while the detrusor contracts, with sphincter relaxes to void urine during the evacuation phase. Inhibition of external urethra sphincter (EUS) activity during evacuation is essential for sufficient bladder emptying (18, 49). The absence of suppression on EUS activity during voiding is one feature of the pathological condition referred to as detrusor-sphincter dyssynergia (51). Such a dyssynergic sphincter contraction results in high intravesical pressure and residual urine. Therefore, to achieve near-normal voiding function in patients with detrusor-sphincter dyssynergia, outlet resistance should be reduced.Arising from the puborectalis muscle, EUS innervated by the perineal branch of the pudendal nerve and external anal sphincter (EAS) innervated by the rectal branch of the pudendal nerve are both striated skeletal muscles that contract and relax voluntarily. A study investigating the coordination between the EUS and EAS muscles demonstrated these muscles shared in reflex actions as in dilatation a...

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The Electrical Activity of the Paraurethral and Perineal Muscles in Normal and Pathological Conditions

Cited by 104 publications

References 14 publications

Urodynamic practice in neuro-urological patients: techniques and clinical value

Urodynamic practice in neuro-urological patients: techniques and clinical value

Postmicturition Dribble: A Physiological Phenomenon?

Acute anal stretch inhibits NMDA-dependent pelvic-urethra reflex potentiation via spinal GABAergic inhibition in anesthetized rats

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