Neurophysiological evaluation of bladder dysfunction in lower motor neuron lesions

Introduction: Urinary stress incontinence is almost an exclusively female phenomenon in middle age, may be due to obstetric injury. Patients with bladder dysfunction should undergo neurophysiological examination when it is suspected to happen due to central or peripheral factors Aim of The work: This work was aimed to assess the electrodiagnostic value of sphincteric electromyography, pudendal nerve terminal motor latency, sacral reflexes, and pudendal nerve somatosensory-evoked potentials in bladder dysfunction. Patients and Methods: This study included 20 patients suffering from bladder dysfunction, with Lower motor neuron lesions selected from Tanta and Alexandria University Hospitals. Diagnosis of the patients based on a full history including a detailed urinary sheet followed by a complete physical and neurological examination. Followed by the electrodiagnostic of sphincteric electromyography, pudendal nerve terminal motor latency, sacral reflexes, and pudendal nerve somatosensoryevoked potentials. Results: The sensitivity of motor unit action potential of external anal sphincter parameters in diagnosis of neuropathic lesion include: sensitivity of amplitude 40% , duration 10 %, area 100%, , denervation 100%.The sensitivity of other parameters in diagnosis of neuropathic lesion as following: bulbocavernosus 100%, urethral Sphincter 100%, puborectalis 100%, gracilis 15%, pudendal nerve terminal motor latencies right &left 15%, reflex The bulbocavernosus 10%, Reflex Pudendo-anal 30%, Somatosensory evoked potentials of pudendal nerve 100%. Conclusion: This study results address the significance of using combined motor unit action potential parameters of different muscles to increase sensitivity for the detection of neuropathic changes in bladder dysfunction.