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Which patients need referral for anal sphincter electromyography?
1Institute of Clinical Neurophysiology, Division of Neurology, University Medical Center, Ljubljana, Slovenia. simon.podnar@kclj.si
Muscle & Nerve
|November 25, 2005
Summary
Needle electromyography (EMG) of the external anal sphincter (EAS) can diagnose neuropathic conditions in patients with pelvic dysfunction. Bladder issues and perineal sensory loss indicate suitability for this diagnostic test.
Area of Science:
- Neurology
- Urology
- Gastroenterology
Background:
- Pelvic floor dysfunction, including urinary, bowel, and sexual issues, can stem from lower sacral nerve damage.
- Needle electromyography (EMG) of lower sacral myotomes, specifically the external anal sphincter (EAS), is a diagnostic tool for these conditions.
Purpose of the Study:
- To identify the clinical characteristics of patients who would benefit from needle EMG of lower sacral myotomes.
- To determine the diagnostic yield of EAS EMG in patients with suspected sacral neuropathic conditions.
Main Methods:
- Retrospective review of medical records for 193 patients undergoing quantitative concentric needle EMG of the EAS.
- Bivariate and multivariate statistical analyses, including ordinal logistic regression, were used to evaluate findings.
Main Results:
- Neuropathic changes in the EAS were identified in 44% (85 out of 193) of patients.
- Bladder-emptying difficulties and perineal sensory loss were significantly associated with neuropathic EMG findings.
Conclusions:
- While specific referral guidelines were not established, patients presenting with bladder-emptying difficulties and perineal sensory loss are the most appropriate candidates for EAS EMG.
- This testing aids in diagnosing neuropathic conditions affecting the lower sacral segments in patients with functional pelvic disorders.
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