[Neurological diagnosis of lower urinary tract dysfunction].

Abstract

Background: Neurophysiological investigations are infrequently utilized in the diagnostic workup of lower urinary tract symptoms (LUTS).

Objective: To determine the potential contributions of neurophysiological assessments in the diagnostic process of LUTS and their integration into systemic neurological and psychosomatic disorders.

Materials and methods: This study elucidates the role of neurophysiological tests specific to pelvic floor diagnostics, namely pudendal nerve somatosensory-evoked potentials (SEP) and external anal sphincter electromyography (EMG), through the presentation of two clinical case reports.

Results: When combined with clinical history, physical examination, and urodynamic studies, pudendal SEP and external anal sphincter EMG facilitate both diagnostic precision and the topographic localization of LUTS. This allows, particularly in conjunction with supplementary imaging modalities such as magnetic resonance imaging (MRI), for a definitive diagnosis and, consequently, the formulation of individualized, targeted therapeutic strategies.

Conclusion: The increased application of specific neurophysiological methods in the diagnostic evaluation of LUTS is warranted, particularly in complex cases. This approach not only enhances diagnostic accuracy but also aligns with the goal of developing personalized, specific, and resource-efficient therapeutic interventions.