Olsen A L, Benson J T, McClellan E
Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City 52242-1080, USA.
Neurourol Urodyn. 1998;17(5):531-5. doi: 10.1002/(sici)1520-6777(1998)17:5<531::aid-nau9>3.0.co;2-e.
Needle electromyography (EMG) of the striated urethral sphincter is the only technique that permits detection of individual motor unit action potentials (MUAPs) and is a valuable diagnostic tool in the evaluation of women with urinary incontinence and voiding disorders. The purpose of this study was to compare two methods of urethral needle EMG with respect to the number of MUAPs identified, the amount of patient discomfort, and the duration of the examination. Twenty consecutive women referred for electrodiagnostic testing to evaluate symptoms of urinary incontinence and/or voiding dysfunction underwent both methods of the needle examination in a prospective randomized cross-over study design with each patient acting as her own control. A full cross-over analysis was conducted to detect period and sequence effects using analysis of variance with a power of 0.85 and a significance level of P < 0.05. Twice as many MUAPs were identified using the periurethral approach (8.8 versus 3.9) with a mean difference of 5.0 (P=0.0008). There was a non-significant trend to greater patient discomfort with the periurethral approach; however, the discomfort was generally rated as mild to moderate. The length of time required to count all identifiable MUAPs did not vary significantly between the two methods. We conclude that the periurethral approach is superior to the transvaginal approach with respect to the quantity of electrodiagnostic information obtained and propose that this method be standardized to characterize more accurately the neurogenic component of urinary incontinence and voiding dysfunction for future electrodiagnostic studies.
横纹肌尿道括约肌针电极肌电图（EMG）是唯一能够检测单个运动单位动作电位（MUAPs）的技术，是评估尿失禁和排尿障碍女性患者的一项重要诊断工具。本研究的目的是比较两种尿道针电极EMG方法在识别MUAPs数量、患者不适程度以及检查持续时间方面的差异。在一项前瞻性随机交叉研究设计中，连续20名因电诊断测试以评估尿失禁和/或排尿功能障碍症状而转诊的女性接受了两种针电极检查方法，每位患者自身作为对照。采用方差分析进行全面的交叉分析，以检测时期和顺序效应，检验效能为0.85，显著性水平为P < 0.05。采用尿道周围入路识别出的MUAPs数量是经阴道入路的两倍（8.8个对3.9个），平均差异为5.0（P = 0.0008）。尿道周围入路使患者不适程度有增加的趋势，但无统计学意义；然而，不适程度一般评定为轻度至中度。两种方法在计数所有可识别的MUAPs所需时间上无显著差异。我们得出结论，就获得的电诊断信息量而言，尿道周围入路优于经阴道入路，并建议将该方法标准化，以便更准确地描述尿失禁和排尿功能障碍的神经源性成分，供未来的电诊断研究使用。
