Cystometry and sphincter electromyography

Gas cystometry combined with electronically integrated sphincter electromyography provides a rapid and effective screening technique for evaluation of patients with disorders of micturition secondary to neurologic dysfunction. The most frequent cystometric patterns are (1) detrusor hyperreflexia secondary to interruption of the cortico-regulatory tracts and (2) detrusor areflexia secondary to impairment of the segmental innervation of the detrusor muscle. To observe these patterns it is necessary to perform detrusor reflex activation procedures, including change in posture, administration of bethanechol, and urethral and rectal distention. The two prinicpal sphincter disturbances observed with electronically integrated electromyography are detrusor sphincter dyssnergia and uninhibited sphincter relaxation. The delineation of combination of abnormal cystometric and sphincter responses provides for rational selection of pharmacologic and surgical therapy.