title: Electromyography of the external anal sphincter: comparison between needle and surface electrodes.
abstract: OBJECTIVE
  Electromyography of the external anal sphincter is frequently used when investigating patients with defecation disorders. Investigations are often performed using an invasive technique by perineal insertion of a needle or wire electrode. The aim of the present study was to investigate whether surface electromyography, with electrodes applied to the perineal skin, is a reliable method in the diagnosis of paradoxical anal sphincter reaction.
  
  
  METHODS
  Seventy-one patients with defecation disorders participated in the present study. They were investigated with electromyography of the external anal sphincter using surface and needle electrodes.
  
  
  RESULTS
  In 65 of 71 (92 percent) patients the electromyography recording showed the same result during straining using surface electrodes when compared with needle electrodes. Twenty-two of these 65 patients had paradoxical anal sphincter reaction, and 43 patients had decreased electromyography activity. In 6 of 71 (8 percent) patients the electromyography recording showed a different pattern during straining using surface electrodes when compared with needle electrodes.
  
  
  CONCLUSIONS
  The present study demonstrates a good correlation between surface electrodes applied to the perineal skin and concentric needle electrodes in the diagnosis of paradoxical anal sphincter reaction. Noninvasive electromyography recordings of the external anal sphincter are often preferred in the diagnosis of paradoxical anal sphincter reaction.
authors.affiliation: Department of Gynecology and Obstetrics, Karolinska Institutet at Danderyd Hospital, Stockholm, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: López
authors.forename: B Y
authors.initials: BY
authors.lastname: Nilsson
authors.forename: A
authors.initials: A
authors.lastname: Mellgren
authors.forename: J
authors.initials: J
authors.lastname: Zetterström
authors.forename: B
authors.initials: B
authors.lastname: Holmström
mesh_terms: D001003:Anal Canal / Q000503:physiopathology*; D003248:Constipation / Q000175:diagnosis; D004566:Electrodes; D004567:Electrodes, Implanted; D004576:Electromyography / Q000295:instrumentation*; D005242:Fecal Incontinence / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged