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01-05-2013 | Original Article

Electrophysiological evaluation of the pudendal nerve and urethral innervation in female stress urinary incontinence

Authors: Geraldo de Aguiar Cavalcanti, Gilberto Mastrocola Manzano, Karlo Faria Nunes, Lydia Maria Pereira Giuliano, Tatiane Almeida de Menezes, Homero Bruschini

Published in: International Urogynecology Journal | Issue 5/2013

Abstract

Introduction and hypothesis

Although still a matter of debate, stress urinary incontinence (SUI) may be accompanied by damage to urethral and pelvic floor innervations, thus promoting dysfunctions of the urethral support and sphincteric closure mechanisms. The aim of this study was to analyze the pelvic floor and urethral innervations through pelvic electrophysiological tests to identify whether neurological alterations interfere with urinary continence and urethral functional activity.

Methods

This prospective study included 52 women, 33 with clinically and urodynamically proven SUI and 19 continent volunteers matched for age, height, parity, and number of vaginal deliveries by the propensity score method. The patients were divided according to the severity of urinary loss evaluated by measuring abdominal leak point pressure (ALPP). Pudendal nerve terminal motor latency (PNTML), pudendal somatosensory evoked potential (SSEP) latencies, urethral and clitoral sensory thresholds, and urethroanal reflex latency were tested.

Results

SUI and control subjects did not differ in PNTML, SSEP latency, and clitoral sensory thresholds. However, reduced responsiveness to urethral electrosensitivity and prolonged urethroanal reflex latency were detected in most incontinent patients. In addition, urethral electrosensitivity was altered in suspected intrinsic sphincteric dysfunction.

Conclusions

Urethral afferent pathways can be altered in women with SUI and may play an important role in evoking intrinsic sphincteric dysfunction.

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Title: Electrophysiological evaluation of the pudendal nerve and urethral innervation in female stress urinary incontinence
Authors: Geraldo de Aguiar Cavalcanti
Gilberto Mastrocola Manzano
Karlo Faria Nunes
Lydia Maria Pereira Giuliano
Tatiane Almeida de Menezes
Homero Bruschini
Publication date: 01-05-2013
Publisher: Springer-Verlag
Published in: International Urogynecology Journal / Issue 5/2013
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-012-1931-8

At a glance: The STEP trials

Springer Medicine

Electrophysiological evaluation of the pudendal nerve and urethral innervation in female stress urinary incontinence

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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