Kliesch Uta, Reitz André
Neurologie Zentralschweiz AG, Maria-Hilf-Strasse 9, 6430, Schwyz, Schweiz.
KontinenzZentrum AG Zürich, Witellikerstrasse 40, 8032, Zürich, Schweiz.
Urologie. 2025 Feb;64(2):149-156. doi: 10.1007/s00120-024-02495-0. Epub 2025 Jan 14.
Neurophysiological investigations are infrequently utilized in the diagnostic workup of lower urinary tract symptoms (LUTS).
To determine the potential contributions of neurophysiological assessments in the diagnostic process of LUTS and their integration into systemic neurological and psychosomatic disorders.
This study elucidates the role of neurophysiological tests specific to pelvic floor diagnostics, namely pudendal nerve somatosensory-evoked potentials (SEP) and external anal sphincter electromyography (EMG), through the presentation of two clinical case reports.
When combined with clinical history, physical examination, and urodynamic studies, pudendal SEP and external anal sphincter EMG facilitate both diagnostic precision and the topographic localization of LUTS. This allows, particularly in conjunction with supplementary imaging modalities such as magnetic resonance imaging (MRI), for a definitive diagnosis and, consequently, the formulation of individualized, targeted therapeutic strategies.
The increased application of specific neurophysiological methods in the diagnostic evaluation of LUTS is warranted, particularly in complex cases. This approach not only enhances diagnostic accuracy but also aligns with the goal of developing personalized, specific, and resource-efficient therapeutic interventions.
神经生理学检查在膀胱过度活动症(LUTS)的诊断检查中很少使用。
确定神经生理学评估在LUTS诊断过程中的潜在作用,以及它们如何融入系统性神经和身心疾病的诊断中。
本研究通过两个临床病例报告,阐明了盆底诊断特有的神经生理学测试的作用,即阴部神经体感诱发电位(SEP)和肛门外括约肌肌电图(EMG)。
当与临床病史、体格检查和尿动力学研究相结合时,阴部SEP和肛门外括约肌EMG有助于提高LUTS的诊断准确性和定位。这尤其与诸如磁共振成像(MRI)等辅助成像方式相结合时,能够实现明确诊断,从而制定个性化、有针对性的治疗策略。
在LUTS的诊断评估中,尤其是在复杂病例中,增加特定神经生理学方法的应用是有必要的。这种方法不仅提高了诊断准确性,还符合开发个性化、特定且资源高效治疗干预措施的目标。