Detection of Innervation zones and IZ distribution in the urethral sphincter through circumferential surface EMG

Gerretsen, Reza and Cescon, Corrado and Farina, Dario and Wijkstra, Hessel and Heesakkers, John (2003) Detection of Innervation zones and IZ distribution in the urethral sphincter through circumferential surface EMG. In: XXXIII Annual meeting of the International Continence Society, 5-9 Oct 2003, Florence, Italy.

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Abstract

The main objective of this work was to analyse the EMG signals detected from the anal and urethral sphincters during sacral nerve stimulation (SNS). The signals were acquired at the UMC St. Rambaud Urology Department in Nijmegen (NL). Sixteen subjects participated to the experiment: two with SNS during a Brindley operation for surgical electrode implantation and 14 with percutaneous needle electrodes (PNE) for SNS. The EMG signals were detected with different configurations of anal and urethral probes. The 64 channels acquisition system developed by the University of Nijmegen allowed the simultaneous detection of signals from an anal probe with three circumferential arrays (48 electrodes) and from an 8 electrode urethral probe. Alternatively, a three circumferential arrays (36 electrodes) urethral probe and a 16 electrodes anal probe could be used for signal detection. The output trigger signal generated by the stimulator was acquired for 7 subjects as an additional channel and the EMG M-waves were extracted as the average value of at least 20 triggered and superimposed EMG responses. The stimulation needle was positioned close to the sacral nerve roots at the level of the sacral vertebrae S3, S4 and S5, left and right side for the PNE patients. During the Brindley operation, the stimulation electrode was inserted directly in the sacral nerve. An EMG acquisition was performed for each value of injected current (ranging from 2 to 10 mA) and each position of the stimulation needle.

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