Complex repetitive discharges during urethral sphincter EMG: Clinical correlates

Complex repetitive discharges (CRDs) are a form of abnormal needle electrom yographic (EMG) activity associated with a variety of neuromuscular disorde rs, including chronic denervation. Urethral CRDs have also been associated with symptoms of voiding dysfunction. We reviewed the findings of 351 conse cutive urethral sphincter EMG studies to characterize the patients with CRD s in our patient population and further to characterize the peri-operative course of any patient with urethral CRDs who underwent surgery for genuine stress incontinence (GSI). Among the 351 women studied, a subgroup of 27 (8 %) women demonstrated CRDs during their study. Patients with CRDs were more likely to report the symptom of strain voiding (48% of patients with CRDs, 18% of patients without CRDs; chi((1))(2) = 17.6, P < 0.001). Patients wit h CRDs were also more likely to have undergone prior urethral dilation (15% of patients with CRDs versus 2% of patients without CRDs, chi((1))(2) = 9. 5, P < 0.01). Patients with CRDs were similar to patients without CRDs with respect to symptoms of incontinence and history of hysterectomy or surgery for incontinence. Ten patients who had urethral CRDs underwent surgery for their GSI with a 90% success rate. The duration of post-operative catheter ization did not differ from that of our general population of patients unde rgoing similar procedures. Urethral CRDs appear to be a non-specific findin g, and it is premature to alter the approach to patients with lower urinary tract dysfunction for this reason. (C) 2000 Wiley-Liss, Inc.