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The Measurement of Vesical Detrusor Electromyographic Activity During Nerve-Sparing Radical Hysterectomy

Objective: To evaluate the feasibility for confirming the preservation of the parasymphathetic nerve pathway innervating the bladder during nerve-sparing radical hysterectomy (RH). Methods: A total of 20 patients underwent nerve-sparing RH. Intraoperative electrical stimulation (IES) were performed on the root of pelvic splanchnic nerve (PSN) trunk while recording the electromyographic (EMG) activity of the vesical detrusor. The average duration achieving residual urine ≤50 mL and urodynamic study (UDS) was observed. Results: Evoked potentials were recorded when stimulating, in 18 patients who were referred IES-positive. Its duration was 9.89 days. The UDS results indicated that all voided normally. The remaining 2 IES-negative cases with no evoked potentials had longer duration and the micturitions were performed using abdominal pressure. Conclusion: During nerve-sparing RH, IES based on the measurement of EMG activity is a useful tool for confirmation of the preservation of parasymphathetic nerve pathway innervating the bladder and prediction of the postoperative bladder function.