Value of electrophysiological assessment after surgical treatment of XXXX .

@entity1 @entity3570 @entity1494 @entity362 @entity73 @entity2055 @entity10145
PURPOSE: This study was conducted in @entity1 treated surgically for @entity3570 between 1994 and 2000 to determine the value of electrophysiological parameters for followup in comparison with clinical, radiological and urodynamic findings. MATERIALS AND METHODS: Electrophysiological examination was performed based on electromyographic detection of perineal muscle activity with evaluation of the sacral reflexes and measurement of lower limb and perineal evoked potentials. Clinical and radiological assessment consisted of physical examination, kidney ultrasonography and retrograde cystouretrography. Urodynamic assessment included determination of urethral pressure profile, bladder activity, compliance, voiding pressure and sphincter synergy. A total of 45 @entity1 were included in the study. In 28 cases electrophysiological assessment was performed routinely in 20 @entity1 (group 1) before and after (6 months and annually thereafter) surgical treatment (mean followup 30 months) and in 8 @entity1 (group 2) only after surgical treatment (mean followup 65 months). Electrophysiological findings were correlated with the urodynamic and clinical findings. Sensitivity, specificity and positive and negative predictive values were calculated. In 17 @entity1 (group 3) electrophysiological assessment was performed only once either before or after surgery. RESULTS: Electrophysiological assessment with combined electromyographic detection and perineal evoked potentials was highly sensitive in predicting @entity73 , particularly vesico-sphincter @entity2055 (sensitivity 100%) or @entity1494 (sensitivity 86%). Specificity of perineal evoked potentials for detecting urodynamic dysfunction was 90%. Electromyographic detection and perineal evoked potentials also demonstrated satisfactory sensitivity in confirming @entity73 (sensitivity 79%, negative predictive value 90%). CONCLUSIONS: Electromyographic detection and perineal evoked potentials are valuable for assessment of @entity1 after surgical treatment of @entity3570 . Because these techniques are minimally invasive and highly reproducible, they are suitable for baseline assessment in most cases (tethered cord, @entity362 ). Urodynamic assessment should be reserved for @entity1 at high risk for secondary neurogenic @entity1494 such as myelomeningocele or @entity10145 .
