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Dysfunctional voiding in women: which muscles are responsible?
F M Deindl1, D B Vodusek, C Bischoff
1Department of Urology, Technical University of Munich, Germany.
British Journal of Urology
|January 12, 1999
Summary
This study used electromyography (EMG) to identify two distinct groups of women experiencing dysfunctional voiding. Differentiating these groups through EMG is crucial for effective treatment and improved outcomes.
Area of Science:
- Urology
- Neurophysiology
- Pelvic Floor Rehabilitation
Background:
- Dysfunctional voiding and urinary retention in women can stem from complex neuromuscular issues.
- Accurate diagnosis is essential for targeted therapeutic interventions.
Purpose of the Study:
- To analyze the striated external urethral sphincter (EUS) and pelvic floor muscles in women with voiding dysfunction using two EMG techniques.
- To differentiate patient groups based on EMG findings for therapeutic relevance.
Main Methods:
- Fifteen women with voiding dysfunction and urinary retention underwent neurological, urological, and urodynamic assessments.
- Kinesiological EMG of pubococcygeal and EUS muscles, plus concentric-needle EMG of the EUS, were performed.
Main Results:
- Inappropriate pelvic floor activation occurred in 11 women; EUS activation in four.
- Concentric-needle EMG identified complex repetitive discharges in the EUS of four women.
- Biofeedback improved pubococcygeal activation but not EUS complex repetitive discharges.
Conclusions:
- Urodynamics combined with kinesiological EMG identified two distinct groups of women with dysfunctional voiding.
- Concentric-needle EMG is a mandatory diagnostic tool for further evaluation.
- Therapeutic strategies should be tailored based on the identified patient subgroups.