NEUROPHYSIOLOGIC TESTS OF THE UROGENITAL SYSTEM
 
Patients suffering from neurological illnesses such as multiple sclerosis, traumatic lesions of the spinal cord, and have erectile dysfunction, urination or defecation problems , need a more specialized investigation of their lower nerves. This can be achieved with the Neurophysiologic tests in our Center.
However its usefulness is not limited in persons with obvious neurological problems. Neurophysiologic control is also advisable in persons with sexual dysfunction, urinary dysfunction, when there is a suspicion of terminal nerve dysfunction without  an overt neurological problem.
 
In our Center  we have the equipment and the ability to perform the five main categories of Neurophysiologic tests of the lower urogenital system that can offer important help in the diagnosis and the treatment of those diseases:
 
 
A) Pudendal Nerve Stimulation

 Pudendal Nerve Stimulation (PNS) or Pudendal Nerve Terminal Motor Latency (PNTML) has diagnostic and prognostic value in the care of patients with fecal incontinence and in other patients with pelvic floor dysfunction in whom it is important to identify and quantify the nature of neuromuscular injury.
PNS is a common and simple study that measures the latency through a direct reflex between stimulator site and recording site.
The St. Marks probe is used for latency measurement between stimulator site and recording site (anal sphincter). Pudendal nerve conduction measures the reflex via the brains. PNS can also be used for urinary incontinence studies when the sphincter is stretched after childbirth. A trace example you can see here .
 
B) Free Run EMG

Sphincter electromyo-graphy (EMG) is the recording of electrical potentials generated by depolarization of the striated muscles involved in the active continence mechanism. The method yields information on the voluntary control of the sphincter muscles and the coordination between the detrusor and the sphincter apparatus during bladder filling and during micturition .
Sphincter EMG may be used for recording of the activity in the urethral striated sphincter, the anal sphincter or the pelvic floor muscles - or all sphincters simultaneously. Routine EMG as part of urodynamic studies usually employs 1 or 2 channels for recording from the urethral and/or anal sphincter muscle.
Furthermore Free Run EMG offers excellent functionality to measure Corpus Cavernosum EMG (ccEMG) .
 
C) Motor Nerve Conduction

The purpose of the Motor Nerve Conduction test is to measure the nerve conduction velocity of the dorsal nerve of the penis.
To make this recording, the dorsal nerve of the penis is stimulated on the dorsum of the glans penis. Recording takes place on the dorsum of the penis and at its base .
The distance between the recording electrodes is divided by the difference in the latency between the dorsal and the base response to calculate conduction velocity.
 
D) Sacral Reflex

The Sacral Reflex or Bulbo Cavernosum Reflex program offers stimulation of the dorsal nerve of the penis or clitoris and records reflexes via the brain taken from pelvic floor muscles structures .
The latency from stimulation to response is measured. The Sacral Reflex can also be used for measurement of Vesico-Urethral or Vesico-Anal Reflexes and Anal Sphincter responses.

 E) Sensory Threshold

The Sensory Threshold program offers stimulation only. It gives you a visual detection of the reaction on a stimulus on penis, clitoris or vesical impulse.