Assessment of pelvic floor disorders using electromyography

  • Research type

    Research Study

  • Full title

    Single site pilot study to assess whether pelvic floor dysfunction is the underlying aetiology in a variety of lower urinary tract symptoms

  • IRAS ID

    284555

  • Contact name

    Eskinder Solomon

  • Contact email

    Eskinder.solomon@gstt.nhs.uk

  • Sponsor organisation

    Guy's and St. Thomas' NHS Foundation Trust

  • Duration of Study in the UK

    1 years, 0 months, 1 days

  • Research summary

    Background:

    The pelvic floor comprises many individual muscles and layers. They play an important role in preventing complaints of urinary, faecal and sexual dysfunction (sleep-related painful erections), prolapse and pelvic pain.

    By measuring the electrical signals, we can define normal, overactive, underactive and non-functioning pelvic floor muscles.

    By identifying pelvic floor dysfunction in patients, we will be able to create personalised treatment plans which are likely to be more effective. This is in line with the NHS long-term plan which aims to offer more insight, choice and control to people affected by conditions affecting their health and wellbeing.

    Aim:

    To assess how the pelvic floor activity in asymptomatic individuals (n=12) compares to six different patient cohorts (n = 12 / cohort) with symptoms consistent with pelvic floor dysfunctions. These studies aim to identify:

    1. Patients with urinary incontinence on coughing/sneezing who can contract their pelvic floor muscles.

    2. The cause of functional obstruction (patients who have difficulty urinating as they’re unable to relax their pelvic floor/urinary sphincter).

    3. Patients who can relax their pelvic floor muscles following sacral neuromodulation (bladder electrical stimulator) for functional obstruction.

    4. Pelvic floor dysfunction in patients with painful nocturnal erections.

    5. Pelvic floor dysfunction in patients with pelvic pain.

    6. If detrusor overactivity is preceded by urethral relaxation.

    Protocol:

    Each participant will undergo a pelvic floor assessment (~15 minutes), requiring insertion of an endo-anal probe into their vagina or anus to measure electrical activity of the pelvic floor. With the device in-situ, participants will perform a series of maximum voluntary contractions and endurance contractions.

    In addition, cohort 6 will undergo a urodynamics test (assessing bladder function requiring a urethral catheter) with the endo-anal probe in-situ. Cohort 3 will undergo another pelvic floor assessment 6 months post sacral neuromodulation implantation.

    All participants will be recruited from Guy’s Hospital.

  • REC name

    West Midlands - Black Country Research Ethics Committee

  • REC reference

    24/WM/0111

  • Date of REC Opinion

    19 Jul 2024

  • REC opinion

    Further Information Favourable Opinion