Under a Pelvic floor EMG one understands a method for the diagnosis of bladder emptying disorders. The function and activity of the muscles can be recorded and pathological changes can be determined.
What is the pelvic floor EMG?
A pelvic floor EMG is an electromyography of the pelvic floor muscles. Electromyography is an additional examination of uroflowmetry and is used to quantify and then assess the pelvic floor muscles.
Uroflowmetry includes various examination methods for diagnosing bladder emptying disorders. During the examination using pelvic floor electromyography, muscle action potentials of the striated pelvic floor muscles and the sphincter muscles (sphincter muscles) are recorded. Muscle action potentials are electrical impulses that are triggered by muscle activity.
The record of muscle action potential is called an electromyogram. In addition to being used for diagnostics, this examination method can be used for therapeutic purposes with the corresponding additional utensils such as an acoustic amplifier or a screen. The focus here is on so-called biofeedback training. This type of training is used to measure the function of the pelvic floor, which is usually not consciously perceptible, and to give the patient feedback. The patient can use this feedback to influence the measurement result and, for example, increase or decrease the muscle tension of the pelvic floor.
Function, effect & goals
A pelvic floor EMG is used to diagnose micturition disorders, stress urinary incontinence, anal incontinence or constipation (constipation).
When examining micturition disorders, no contrast agent is used during pelvic floor electromyography and therefore carries fewer risks than other examination methods. Stress incontinence, also known as so-called stress incontinence, is examined using a needle EMG. With the EMG, a qualitative and quantitative assessment of the urination can be carried out and a possible cause of the incontinence can be found. This diagnostic procedure is also used outside of urology in the area of anal incontinence to assess an anal dysfunction. It is also used in proctology to examine possible pathological opstipation (constipation).
The flow EMG procedure for assessing an existing micturition disorder is one of the most important screening procedures. It should always be noted that the micturition values vary depending on age and gender. Therefore, the patient's medical history is very important to make a meaningful assessment.
In order to achieve an adequate result with the pelvic floor electromyography procedure, the correct positioning of the electrodes is particularly important. In order to derive the corresponding muscle action potentials, an adhesive electrode must be attached in the area of the anus and one as a grounding electrode (indifferential electrode) on the thigh. The so-called needle-pelvic floor EMG does not use adhesive electrodes, but needle electrodes. These are placed directly in the tissue.
The muscle action potentials are recorded using a 2-channel recorder. During a micturition phase, this records a urine flow curve and the function of the pelvic floor muscles. A urologist can use these values and the patient's medical history to make an assessment of micturition behavior.
There are different methods of pelvic floor electromyography. In general, this method can be used to assess the entire striated muscles of the pelvic floor. However, a distinction is made between two possible uses. On the one hand there is the unspecific surface EMG and the simple surface EMG. This is usually sufficient for general assessments of a functional disorder. If specific examinations are to be carried out with the EMG, a rather complex needle EMG is carried out. This achieves specific and more meaningful results than the surface EMG. Although this procedure produces the better results, it is rarely done.
The reason for this is that it is significantly more painful and carries more risks. Nevertheless, in some cases a needle EMG is of great importance, as the spontaneous activity of the individual muscles is recorded separately.This is an advantage if neurological dysfunctions or scarring in the pelvic floor area are present or are to be determined. Basically, the pelvic floor EMG procedure as a sole examination is not conclusive enough to make a final possible diagnosis.
The values vary too much due to the external circumstances, which not only affect the anamnesis (age, previous illnesses), but also the individual tissue structures and the disposition in their function. This is why EMG is considered to be one of many diagnostic methods from uroflowmetry. The results of electromyography are not sufficient as a sole examination and the assessment is therefore risky.
When assessing the measurement results, the specialist pays attention to the function of the urinary bladder. The physiological activity is observed through an increase in muscle tension parallel to the filling of the urinary bladder. Increased or insufficient activity of the urinary bladder are called pathological. During the emptying of the bladder, the sphincter muscles relax. This opens the sphincter muscle and the urine can be drained away. In this phase, an electromyogram should record only minimal or, in the best case, no action potential of the muscles.
If other values are shown, this can be an indication of a pathological neurological finding. The pelvic floor muscles and the sphincter muscle cannot be controlled with corresponding neurological stimuli from the nerves.
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In general, pelvic floor EMG only leads to complications in very rare exceptional cases. Surface electromyography does not involve any risks or subsequent complications; skin irritations from the adhesive electrodes can very rarely occur, which are quickly reduced by ointments.
In very rare cases, needle electromyography can lead to complications. When the needle electrodes are placed in the tissue, nerves or blood vessels can be injured, but this happens so rarely that it can almost be described as hypothetical.
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