ISRN Obstet Gynecol. 2011; 2011: 323421
Spettel S, Kalorin C, De E
Introduction. The diagnosis of detrusor-external sphincter dyssynergia (DESD) is a clinically applicable finding during urodynamic testing. However, there is no consensus regarding diagnostic specifics of electromyography (EMG) or voiding cystourethrography (VCUG). We evaluated a concordance of a two modalities most ordinarily used in clinical practice for a diagnosis of DESD. Methods. Patients were prospectively evaluated by a singular urodynamicist during an academic center as well as retrospectively re-evaluated by an independent urodynamicist for agreement. DESD was determined by increased vegetable patch EMG wake up or a dilated bladder neck/proximal urethra on VCUG during detrusor contraction. Minimal acceptable pattern for agreement was set during 70%. Results. Forty-six patients were diagnosed with DESD with both modalities available. Of these 46 patients, twenty-five were diagnosed by both tests, 11 by VCUG alone as well as 10 by vegetable patch EMG alone. Binomial testing demonstrated a proportion of agreement was 54% (95% CI 39% to 68%). Conclusion. We found significant disagreement between a two modalities, identical to formerly reported findings using needle EMG, as well as you expand a applicability of our data to a infancy of clinicians who use vegetable patch EMG electrodes. This further supports a idea which a combined use of EMG as well as VCUG for diagnosis can identify more cases of DESD than either modality alone.
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