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• W2134497497 abstract "You have accessJournal of UrologyUrinary Diversion: Bladder Reconstruction, Augmentation, Substitution, Diversion I1 Apr 2010749 INCREASED BASAL RESTING TONE DURING EMG BIOFEEDBACK IS ASSOCIATED WITH IMPROVED VOIDING FOR PATIENTS WITH ORTHOTOPIC NEOBLADDER DYSFUNCTION Laura Stansell, Diane Newman, Laurie Magerfleisch, Alan Wein, Thomas Guzzo, and S. Bruce Malkowicz Laura StansellLaura Stansell More articles by this author , Diane NewmanDiane Newman More articles by this author , Laurie MagerfleischLaurie Magerfleisch More articles by this author , Alan WeinAlan Wein More articles by this author , Thomas GuzzoThomas Guzzo More articles by this author , and S. Bruce MalkowiczS. Bruce Malkowicz More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1301AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Patients who undergo bladder replacement can achieve effective volitional voiding. Some individuals however have difficulty achieving continence, or more commonly demonstrate deterioration of pouch function over time. Biofeedback is a viable means of pelvic floor muscular rehabilitation after the loss of neural and detrusor contribution to normal mechanical micturition. The objective of this study was to evaluate the impact of electromyography (EMG) biofeedback on the rehabilitation of voiding status in a subset of orthotopic bladder replacement patients (Studer pouch). METHODS EMG biofeedback and cystectomy databases were cross referenced to obtain the treatment cohort. Patient evaluation included clinic interview, AUASS evaluation, and EMG biofeedback training. This consisted of electrode placement at 10 and 4 o'clock about the anus. The patient was then tasked to isolate, contract, and relax their pelvic muscles. Each therapy was verbally cued with real time visual feedback. Outcomes were measured by patient perception, nocturia events, and assessment of bladder emptying. RESULTS From 1996 to 2009, 27 patients with orthotopic diversion were directed toward EMG biofeedback. Patients underwent one to eight treatments [mean of 2.5]. Twenty of 27 (74.1%) noted significant self-reported improvement in their urinary symptoms. Eight patients underwent only one treatment and of those, seven achieved continence or decreased their catheterization requirement. Six remained unchanged both symptomatically and objectively despite multiple sessions (one incontinent, five in full retention). Of those who improved, 50% resolved nocturnal enuresis, 45% decreased nocturia events, and 60% reported complete emptying and no further incontinence. Optimal outcome was associated with a mean basal resting tone of 2.91 mV [range 0.48-6.99]. Those who recorded no change had a mean pelvic floor musculature resting tone of 0.93 mV [range 0.43-2.28]. CONCLUSIONS Patients with orthotopic neobladder dysfunction may benefit from EMG biofeedback to correct nocturia and retention. Those patients who achieve higher basal resting tone of their pelvic floor musculature are more likely to attain complete emptying and decreased nocturnal events. The prospective evaluation of this technique in initial rehabilitation and in cases of pouch decompensation is appropriate. Philadelphia, PA© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e293 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Laura Stansell More articles by this author Diane Newman More articles by this author Laurie Magerfleisch More articles by this author Alan Wein More articles by this author Thomas Guzzo More articles by this author S. Bruce Malkowicz More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2134497497 title "749 INCREASED BASAL RESTING TONE DURING EMG BIOFEEDBACK IS ASSOCIATED WITH IMPROVED VOIDING FOR PATIENTS WITH ORTHOTOPIC NEOBLADDER DYSFUNCTION" @default.
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