RESUMO
Se estudiaron 32 mujeres voluntarias normales, con edades que oscilaron entre los 20 y 68 años. Se les provocó el Reflejo Pudendo Profundo (RPP) mediante un electrodo de superfície especial que tiene la ventaja de servir para el registro del esfínter anal y también para el estímulo del nervio pudendo. Se describe la técnica para la obtención del reflejo tras la estimulación de dicho nervio a nivel de la espina isquiática. Se obtuvo una latencia media de 36,18 mseg ñ 4,29 con una amplitud media de 306,11 uv ñ DS 227,15. Al efectuar el RPP se realiza un reflejo pudendo-anal que difere del clássico reflejo bulbocavernoso en cuanto a la localización del estímulo, de las latencias, y también en su vía aferente aunque comparten un trayecto común en parte del mismo
Assuntos
Adulto , Pessoa de Meia-Idade , Humanos , Feminino , Canal Anal/inervação , Clitóris/inervação , Reflexo/fisiologia , Estimulação Elétrica , Potenciais Evocados/fisiologia , Medula Espinal/fisiologiaRESUMO
Se estudiaron 32 mujeres voluntarias normales, con edades que oscilaron entre los 20 y 68 años. Se les provocó el Reflejo Pudendo Profundo (RPP) mediante un electrodo de superfície especial que tiene la ventaja de servir para el registro del esfínter anal y también para el estímulo del nervio pudendo. Se describe la técnica para la obtención del reflejo tras la estimulación de dicho nervio a nivel de la espina isquiática. Se obtuvo una latencia media de 36,18 mseg ñ 4,29 con una amplitud media de 306,11 uv ñ DS 227,15. Al efectuar el RPP se realiza un reflejo pudendo-anal que difere del clássico reflejo bulbocavernoso en cuanto a la localización del estímulo, de las latencias, y también en su vía aferente aunque comparten un trayecto común en parte del mismo (AU)
Assuntos
Adulto , Pessoa de Meia-Idade , Idoso , Humanos , Feminino , Reflexo/fisiologia , Clitóris/inervação , Canal Anal/inervação , Medula Espinal/fisiologia , Estimulação Elétrica , Potenciais Evocados/fisiologiaRESUMO
The objective of this work was to study two pudendal anal reflexes: Deep Pudendal Reflex (DPR) and classical Bulbocavernosus Reflex (BCR) in women with primary and recurrent genital prolapse to obtain support to the hypothesis of pelvic nerve damage in patients with pelvic floor disorders. 124 women were studied: 68 were normal; 38 with genital prolapse (GP); and 18 with recurrent GP. Clinical and electrophysiological studies were carried out. Delayed reflex responses were found in 44/56 of patients (79%). [27/38 in genital prolapse group (71%); 17/18 in recurrent GP group (94%)]. The evaluation of pelvic floor reflex responses are tests to be taken into account in the diagnosis and management of pelvic floor disorders.
Assuntos
Contração Muscular/fisiologia , Diafragma da Pelve/inervação , Reflexo/fisiologia , Prolapso Uterino/fisiopatologia , Adulto , Idoso , Canal Anal/inervação , Clitóris/inervação , Estimulação Elétrica , Feminino , Humanos , Pessoa de Meia-Idade , Neurônios Motores/fisiologia , Nervos Periféricos/fisiopatologia , Peritônio/inervação , Complicações Pós-Operatórias/fisiopatologia , Tempo de Reação/fisiologia , Recidiva , Prolapso Uterino/cirurgiaRESUMO
32 healthy women ranging from 20 to 68 years (51.84 +/- 10.36) were tested for Deep Pudendal Reflex (DPR). Dantec 13L40 (St. Mark's) superficial electrodes were used to pick up the responses of the external anal sphincter. These devices consist of a bipolar stimulating electrode mounted on the tip of the gloved index finger which is inserted into the rectum; 3 cm proximally at the base of the finger are recording electrodes which pick up the contraction response of the anal sphincter. To obtain the DPR the ischial spine is localized on transrectal examination and electrical stimuli given at that side, applying square stimulus of 0.2 ms duration and 0.5 Hz frequency. This stimulates the pudendal nerve as it leaves the pelvis through the greater sciatic notch, before it branches into the inferior rectal (to the anal sphincter) and perineal nerve (to the periurethral striated muscle). The conduction time was measured as the latency from the time of stimulation of the starting point of the reflex response curves. The shortest latency of various responses was accepted and measured in milliseconds (ms). The amplitudes of the responses were measured in microvolts (uv). We obtained reproducible DPR in all subjects. Mean latency was 36.18 +/- 4.29 ms; mean amplitude was 337.50 +/- 218.49 uv (Fig. 1, Table 2). DPR is a pudendal-anal reflex like the bulbo-cavernous reflex, but differs in latency, stimulation localization and afferent limb although both follow a common final afferent pathway.
Assuntos
Canal Anal/fisiologia , Clitóris/fisiologia , Reflexo/fisiologia , Adulto , Idoso , Estimulação Elétrica , Potenciais Evocados , Feminino , Humanos , Pessoa de Meia-Idade , Medula Espinal/fisiologiaRESUMO
32 healthy women ranging from 20 to 68 years (51.84 +/- 10.36) were tested for Deep Pudendal Reflex (DPR). Dantec 13L40 (St. Marks) superficial electrodes were used to pick up the responses of the external anal sphincter. These devices consist of a bipolar stimulating electrode mounted on the tip of the gloved index finger which is inserted into the rectum; 3 cm proximally at the base of the finger are recording electrodes which pick up the contraction response of the anal sphincter. To obtain the DPR the ischial spine is localized on transrectal examination and electrical stimuli given at that side, applying square stimulus of 0.2 ms duration and 0.5 Hz frequency. This stimulates the pudendal nerve as it leaves the pelvis through the greater sciatic notch, before it branches into the inferior rectal (to the anal sphincter) and perineal nerve (to the periurethral striated muscle). The conduction time was measured as the latency from the time of stimulation of the starting point of the reflex response curves. The shortest latency of various responses was accepted and measured in milliseconds (ms). The amplitudes of the responses were measured in microvolts (uv). We obtained reproducible DPR in all subjects. Mean latency was 36.18 +/- 4.29 ms; mean amplitude was 337.50 +/- 218.49 uv (Fig. 1, Table 2). DPR is a pudendal-anal reflex like the bulbo-cavernous reflex, but differs in latency, stimulation localization and afferent limb although both follow a common final afferent pathway.