1000 Section - Integrating Electrodiagnostic Assessment with Conservative Therapies in Stress Urinary Incontinence

Urinary incontinence is a prevalent condition that significantly impacts quality of life, with stress urinary incontinence (SUI) accounting for 50–70% of cases.

This study aims to evaluate the role of electrodiagnosis in assessing neuromuscular function in SUI, serving both diagnostic and prognostic purposes. By identifying the degree of pelvic floor dysfunction, electrodiagnosis may guide individualized treatment planning. We also aimed to assess the therapeutic efficacy of conservative interventions in improving continence outcomes.

Design:

This study included 50 multiparous women presenting with stress incontinence, all had history of vaginal delivery (2-10 deliveries).

Ten matched age nulliparous continent women were included as a control group.

Patients were subjected to urodynamic study and electrodiagnostic studies (including EMG of the external anal & external urethral sphincters and pudendal nerve terminal motor latencies “PNTMLs”)

- Transvaginal pelvic floor electrical stimulation and biofeedback therapy for 8 weeks followed by clinical reassessment

Results: Cystometrogram findings were normal in all patients, indicating the absence of detrusor over activity.
EMG evaluation revealed partial denervation of the external urethral sphincter in 10 patients, while delayed pudendal nerve terminal motor latencies were observed in 21 patients.
Following conservative therapy, 24 patients achieved complete recovery, 18 showed partial improvement, and 8 demonstrated no clinical benefit.
Favorable treatment outcomes were significantly associated with younger age, shorter symptom duration, lower parity, mild EMG-detected sphincter affection and higher baseline maximal urethral closure pressure. These factors appear to contribute to enhanced responsiveness to pelvic floor electrotherapy and biofeedback interventions.

Conclusion: Neurophysiological evaluation plays a pivotal role in determining the severity of SUI and guiding appropriate treatment strategies. Conservative pelvic floor therapy should be prioritized in affected women, given its non-invasive nature, excellent tolerability, absence of adverse effects, and cost-effectiveness. This approach offers a valuable first-line option in the multidisciplinary management of SUI.