Pudendal Nerve Terminal Latency Testing
The pudendal nerve is found in the pelvis. Right and left branches of this nerve extend to the bladder and bowel sphincter muscles. When the nerves and muscles perform normally, we have control of bladder and bowel functions without discomfort. A problem with pudendal nerve function may lead to loss of control of the anal sphincter muscles. Such problems may cause leakage of urine or stool, conditions referred to as urinary incontinence and bowel incontinence. Problems with pudendal nerve and sphincter function may also cause chronic constipation or rectal pain.
PURPOSE: Pudendal nerve terminal latency testing will determine if your pudendal nerve is functioning normally, or if there is any delay or deficit. The results will allow your physician to determine whether a pudendal nerve problem is contributing to any of the conditions mentioned above. This information will permit your physician to develop the best treatment plan for you.
PROCEDURE: You will be asked to undress from the waist down, and wear a patient gown with the opening in the back. A technologist trained in performing this exam will be conducting the test, and will explain everything he or she is going to do. You will be asked to lie on a stretcher, turn to your left side, and bend your knees. An electrode pad (similar to an EKG pad) will be placed on your buttock or thigh. The technician will then put on a rubber glove with an electrode on the index finger. After lubricating his index finger, he will gently insert it into your rectum. This should be no more uncomfortable for you than a rectal exam. The technologist will then send a mild, painless electrical stimulus through the electrode on his finger to your pudendal nerve. This stimulation may cause the muscles of your thigh to twitch involuntarily, but it will be painless. The technologist will then gently rotate his finger to repeat the test on the opposite branch of the nerve. A computer will record the response of your pudendal nerve to the stimulation. A physician will interpret the results and determine if any nerve conduction delays exist. The actual procedure will take 15-20 minutes. Please expect to be in the testing area for about 1 hour.
PREPARATION: Please use two 500 cc warm tap water enema to cleanse the lower bowel prior to the procedure. The enemas may be purchased at any pharmacy, and instructions are on the label. The enema usually takes 15 minutes to work, but may produce results for up to one hour. Please take the first enema 1½ hours before you leave your home. Take the second enema immediately after the first one is expelled.
LOCATION: Pudendal nerve testing is performed in the GI Physiology Lab of the Medical Procedures Unit. The lab is located at the east end of the second floor of the University Hospital, in room 2B355. You will receive an appointment confirmation letter and a map to the lab.
APPOINTMENT DATE:______________________________ TIME:_____________
Information provided by the Michigan Bowel Control Program, October, 2008
