Neurophysiology and neurophysiological evaluation of the pelvic floor

Abstract

This chapter details the neural circuitry that controls the mechanisms that regulate urinary and intestinal functions, describing the afferent and efferent neuronal pathways between the brain and the pelvic organs. After a functional anatomical approach, the neurophysiological investigations valuable in the assessment of patients with urogenital and anorectal dysfunctions are reported. On assessing a patient with neurogenic bladder and bowel dysfunction, different neurophysiological methods are described, in particular electromyography (EMG), sacral reflexes, somatosensory-evoked potential (SEP), motor-evoked potential (MEP), sympathetic skin response (SSR), and pudendal nerve terminal motor latency (PNTML). Moreover, technical advice is given, reporting normative values and discussing neurophysiological tests clinical applications.