Is the Reference Electrode Location Important for the Electromyography Evaluation of the Pelvic Floor in Urodynamic Studies? / 대한배뇨장애요실금학회지

Purpose@#Perineal electromyography (EMG) is a crucial part of urodynamic studies. Many researchers focused on the standardization of techniques in urodynamics, but no study has yet evaluated the differences with various reference electrode placements. The aim of this study was to determine the optimal placement of the reference electrode for recording pelvic floor activity in urodynamic studies. @*Methods@#Children over 6 years of age without anatomic or neurological abnormalities were invited to participate in the study. Four reference electrodes were placed on the right kneecap, the inner surface of the right inner thigh, the right anterior iliac spine (AIS), and the skin over the left gluteal muscles for simultaneous recording. The EMG signal formed by pelvic contraction during forceful straining was recorded both in the supine and sitting positions. The root mean square (RMS) value of each muscle contraction signal was calculated. @*Results@#Twenty-one participants (10 boys and 11 girls) were included. The mean age was 10.19±3.20 years. The highest RMS values were obtained with the reference electrode on the thigh in the supine position and the AIS in the sitting position. Significant differences were found between the mean RMS values of the knee and other locations of reference electrodes in the supine position, as well as between mean RMS values in all regions except the thigh and gluteus in the sitting position. The minimum mean RMS values in both positions were obtained with the reference electrode on the knee. @*Conclusions@#During urodynamic studies, reference electrodes shall be placed on AIS in the sitting and on the inner thigh in the supine position. The knee is not a suitable option for reference electrode placement. This information may help improve EMG recordings in the evaluation of pelvic floor muscles.

Leiomyoma of the urinary bladder in asymptomatic women

Most bladder tumors are derived from the urothelium. Benign mesenchymal tumors are rare. Leiomyomas account for less than 0.43% of all bladder tumors. Genitourinary leiomyomata may arise in any anatomic structure containing smooth muscle. They have been reported to involve single or multiple organs. Since they may also mimic malignant lesions, they should always be considered in the differential diagnosis of any pelvic mass, with a possibility of being asymptomatic and discovered incidentally by radiographic imaging. We, herein, report a case illustrating clinical and pathological features in particular immunohistochemistry, and discuss its etiology and differential diagnosis

The Effect of Urethral Catheterisation on Serum Prostate- Specific Antigen Levels in Male Patients with Acute Urinary Retention

Urethral catheterisation is often used in acute urinary retention (AUR). In this study, we aimed to evaluate the effect of urethral catheterisation on serum prostate-specific antigen (PSA) levels in men with AUR. Our study subjects comprised 35 men with a mean age of 63.7 +/- 7.35 years (range 55-80) who presented with AUR at our department between March 1999 and June 2000. Patients were randomly divided into two groups; 18 patient sunderwent urethral catheterisation in the first group (catheterisation group), while 17 underwent suprapubic percutaneous cystostomy in the second group (cystostomy group). Serum PSA levels before manipulation, and 2 and 12 hours and 7 days after treatment were determined. The change in median PSA values after manipulation was statistically significant in the catheterisation group (p 0.05). The change in serum PSA was not clinically important in any of the patients. These results suggested that urethral catheterisation did not cause a significant alteration in serum PSA in men with AUR retention.