High-Density Surface Electromyography Assessment of Pelvic Floor Dysfunction in Women with Interstitial Cystitis/Bladder Pain Syndrome

No AccessJournal of UrologyAdult Urology1 Dec 2020High-Density Surface Electromyography Assessment of Pelvic Floor Dysfunction in Women with Interstitial Cystitis/Bladder Pain SyndromeThis article is commented on by the following:Editorial Comment Nicholas Dias, Chuan Zhang, Theresa Spitznagle, H. Henry Lai, and Yingchun Zhang Nicholas DiasNicholas Dias University of Houston, Department of Biomedical Engineering, Houston, Texas , Chuan ZhangChuan Zhang University of Houston, Department of Biomedical Engineering, Houston, Texas , Theresa SpitznagleTheresa Spitznagle Department of Physical Therapy, Washington University School of Medicine, St. Louis, Missouri , H. Henry LaiH. Henry Lai Departments of Surgery (Urology) and Anesthesiology, Washington University School of Medicine, St. Louis, Missouri , and Yingchun ZhangYingchun Zhang *Correspondence: Department of Biomedical Engineering, University of Houston, 4849 Calhoun Rd., Rm 373, Houston, Texas 77004 telephone: 713-743-6127; E-mail Address: [email protected] University of Houston, Department of Biomedical Engineering, Houston, Texas View All Author Informationhttps://doi.org/10.1097/JU.0000000000001237AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Up to 85% of women with interstitial cystitis/bladder pain syndrome have pelvic floor dysfunction and hypertonicity. Current evaluation methodologies lack objective measures of pelvic floor muscle activity. We examined the ability of using intravaginal high-density surface electromyography to quantitatively, objectively and noninvasively map pelvic floor muscle activity and innervation zone locations in patients with interstitial cystitis/bladder pain syndrome. Materials and Methods: Fifteen women with interstitial cystitis/bladder pain syndrome and 15 controls underwent 2 sessions of digital pelvic examinations and high-density surface electromyography assessments. The root mean squared amplitude of high-density surface electromyography was first calculated, and the resting root mean squared ratio was then calculated by normalizing the resting electromyography root mean squared to the peak electromyography amplitude reached during maximum voluntary contraction. Innervation zone distributions were obtained from decomposed high-density surface electromyography signals. The correlation between the root mean squared ratio and interstitial cystitis/bladder pain syndrome symptom scores and pelvic floor muscle alignment were investigated in patients with interstitial cystitis/bladder pain syndrome and healthy controls. Results: Women with interstitial cystitis/bladder pain syndrome demonstrated significantly increased resting root mean squared ratios compared to controls (0.155±0.048 vs 0.099±0.041, p=0.0019). Significant correlations were found between resting root mean squared ratio and patient reported pain (rs=0.523, p=0.003), interstitial cystitis symptom (rs=0.521, p=0.003) and problem indices (rs=0.60, p <0.001). In addition, women with interstitial cystitis/bladder pain syndrome were more likely to have shortened pelvic floor muscles (80%, 12 vs 13.3%, 2, p <0.01). Women with shortened pelvic floor muscles demonstrated significantly higher resting root mean squared ratio compared to those with normal pelvic floor muscle length (0.155±0.046 vs 0.107±0.040, p=0.0058). Conclusions: Intravaginal high-density surface electromyography offers an objective and quantitative strategy to noninvasively assess pelvic floor muscle dysfunction in women with interstitial cystitis/bladder pain syndrome. Abundant spatiotemporal muscle activity information captured by high-density surface electromyography allows for mapping innervation zone distributions for major pelvic floor muscles. References 1. : Prevalence of pelvic floor dysfunction in patients with interstitial cystitis. Urology 2007; 70: 16. Google Scholar 2. : Pathophysiology of pelvic floor hypertonic disorders. Obstet Gynecol Clin 2009; 36: 699. Google Scholar 3. : Pelvic floor hypertonic disorders: identification and management. Obstet Gynecol Clin 2009; 36: 707. 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Google Scholar No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsRelated articlesJournal of UrologySep 24, 2020, 12:00:00 AMEditorial Comment Volume 204Issue 6December 2020Page: 1275-1283Supplementary Materials Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.Keywordsmuscle hypertoniapelvic floorinterstitialelectromyographycystitismyofascial pain syndromesMetricsAuthor Information Nicholas Dias University of Houston, Department of Biomedical Engineering, Houston, Texas More articles by this author Chuan Zhang University of Houston, Department of Biomedical Engineering, Houston, Texas More articles by this author Theresa Spitznagle Department of Physical Therapy, Washington University School of Medicine, St. Louis, Missouri More articles by this author H. Henry Lai Departments of Surgery (Urology) and Anesthesiology, Washington University School of Medicine, St. Louis, Missouri More articles by this author Yingchun Zhang University of Houston, Department of Biomedical Engineering, Houston, Texas *Correspondence: Department of Biomedical Engineering, University of Houston, 4849 Calhoun Rd., Rm 373, Houston, Texas 77004 telephone: 713-743-6127; E-mail Address: [email protected] More articles by this author Expand All No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. Advertisement Loading ...