RE: PUDENDAL SOMATOSENSORY EVOKED POTENTIALS IN NORMAL WOMEN
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GERALDO A. CAVALCANTI, HOMERO BRUSCHINI, GILBERTO M. MANZANO, KARLO F. NUNES, LYDIA M. GIULIANO, JOAO A. NOBREGA, MIGUEL SROUGI

Divisions of Urology and Neurology, Federal University of Sao Paulo, UNIFESP and University of Sao Paulo, USP, Sao Paulo, Brazil

Int Braz J Urol, 33: 815-821, 2007

To the Editor:

     Authors have studied pudendal somatosensory evoked potentials (SSEP) in a rather impressive number (n = 38) of healthy women and most important they also studied factors as corporal dimension and obstetric history.
     SSEP is an electrophysiological test that objectively assesses afferent pathways even in unconscious patients. Women with stress urinary incontinence but without overt neurological disease could be studied for some kind of neuropathic lesion with pudendal SSEP. The study of cerebral SSEP cannot reveal the localization of the lesion (central or peripheral nervous system). The study of cerebral and spinal SSEP could reveal the localization of lesion but spinal SSEP are not easily recorded even in healthy subjects and particularly in women.
     Pudendal SSEP is useful in the evaluation of lower urinary tract dysfunction either in patients with peripheral or central nervous system lesions as a part of a more complex neuro-urodynamics investigation. Clinical examination, urodynamics and some uro-neurophysiologic tests (needle electromyography of pelvic floor muscles, sacral reflexes, perineal sympathetic skin response, and pudendal SSEP) can contribute in a more thorough evaluation of the lower urinary tract neuropathic dysfunction.

REFERENCE

1. Vodusek DB: Evoked potential testing. Urol Clin of North Am. 1996; 23: 427-46.

Dr. Christina-Anastasia Rapidi
Neuropathic Bladder Unit
2nd PRM Department
National Rehabilitation Center “EIAA”
Athens, Greece
E-mail: rapidicha@hotmail.com