SMOOTH MUSCLE ELECROMYOGRAPHY

      There are three different types of muscle cells in the human body: striated, cardiac, and smooth muscle. In routine clinical studies, the electrical activity of cardiac muscle (electrocardiography, ECG) and of striated muscle (electromyography, EMG) has been registered for decades. The electrical activity of smooth muscle organs, such as the ureter,
      • Golenhofen K.
      • Hannappel J.
      Normal spontaneous activity of pyeloureteral system in guinea-pig.
      uterus,
      • Wagner G.
      Electrical and mechanical activity in myometrial grafts in the rabbit.
      colon,
      • Riezzo G.
      • Maselli M.A.
      • Pezzolla F.
      • et al.
      In vitro electro-mechanical activity of the human colon: Simultaneous recording of the electrical patterns of the two muscle layers.
      • Ward S.M.
      • Keller R.G.
      • Sanders K.M.
      Structure and organization of electrical activity of canine distal colon.
      duodenum,
      • Bayguinov O.
      • Vogalis F.
      • Morris B.
      • et al.
      Patterns of electrical activity and neural responses in canine proximal duodenum.
      gaster,
      • Renzetti M.L.
      • Wang M.B.
      • Ryan J.P.
      Electrical slow-wave activity from the circular layer of cat terminal antrum.
      trachea,
      • Kondo T.
      • Tamura K.
      • Onoe K.
      • et al.
      In vivo recording of electrical activity of canine tracheal smooth muscle.
      gall bladder,
      • Konture J.W.
      • Scott G.W.
      • Kingma Y.J.
      Electrical activity of canine gallbladder.
      and vessels,
      • Kitamura K.
      • Suzuki H.
      • Ito Y.
      • et al.
      Similarity and diversity of electrical activity in vascular smooth muscles.
      has been registered mainly in a laboratory setting. Smooth muscle EMG did not find widespread clinical use because the previously mentioned organs required surgical exposition before EMG could be performed. In 1988 Gerstenberg and Wagner described registration of the electrical activity of the cavernous smooth muscle.
      • Gerstenberg T.C.
      • Nordling J.
      • Hald T.
      • et al.
      Standardized evaluation of erectile dysfunction in 95 consecutive patients.
      • Wagner G.
      • Gerstenberg T.
      • Levin R.J.
      Electrical activity of corpus cavernosum during flaccidity and erection of the human penis: A new diagnostic method?.
      Subsequently, corpus cavernosum EMG (CC-EMG) attracted much scientific attention because the information on cavernous autonomic innervation and smooth muscle function was crucial for therapeutic decision making in erectile dysfunction.
      • Bührle C.P.
      • Jünemann K.P.
      • Schmid P.
      • et al.
      Corpus cavernosum electromyography in the dog.
      • Merckx L.
      • Schmedding E.
      • de Bruyne R.
      • et al.
      Penile electromyography in the diagnosis of impotence.
      • Stief C.G.
      • Djamilian M.
      • Schaebsdau F.
      • et al.
      Single potential analysis of cavernous electrical activity—a possible diagnosis of autonomic impotence?.
      • Wagner G.
      • Gerstenberg T.
      • Levin R.J.
      Electrical activity of corpus cavernosum during flaccidity and erection of the human penis: A new diagnostic method?.
      These clinical studies were corroborated by experimental data,
      • Höppner C.
      • Stief C.G.
      • Jonas U.
      • et al.
      Rabbit penile corpus cavernosum: Electrical and mechanical activity of isolated strips..
      • Moreno A.P.
      • Campos de Carvalho A.C.
      • Christ G.
      • et al.
      Gap junctions between human corpus cavernosum smooth muscle cells: Gating properties and unitary conductance.
      • Noack T.H.
      • Lammel E.
      • Niederste-Hollenberg A.
      • et al.
      Spontaneous depolarizations in single smooth muscle cells from rabbit penile corpus cavernosum.
      suggesting an important role for CC-EMG in the diagnosis of erectile dysfunction.
      Conflicting reports appeared in the literature on normal and abnormal CC-EMG recordings owing to a missing consensus on the basic principles of the examination and the recording parameters. To unify the efforts to improve CC-EMG and to allow reproducible and comparable recordings, consensus meetings were held and internationally accepted standards agreed upon.
      • Jünemann K.P.
      • Bührle C.P.
      • Stief C.G.
      Current trends in corpus cavernosum EMG: Conclusions of the First International Workshop on Smooth Muscle EMG Recordings/Leiomyogram, April 15 to 17, 1993, Mannheim, Germany.
      • Stief C.G.
      • Jünemann K.P.
      • Kellner B.
      • et al.
      Consensus and progress in corpus cavernosum-EMG.
      Currently, there is a broad consensus among European centers involved in research on CC-EMG. Interest in broader urologic or sexologic areas remains limited owing to a lack of financial resources, and available therapeutic options for many causes of eractile dysfunction dramatically have reduced the need for diagnostic procedures.
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      References

        • Bayguinov O.
        • Vogalis F.
        • Morris B.
        • et al.
        Patterns of electrical activity and neural responses in canine proximal duodenum.
        Am J Physiol. 1992; 263: G887-G895
        • Bührle C.P.
        • Jünemann K.P.
        • Schmid P.
        • et al.
        Corpus cavernosum electromyography in the dog.
        Akt Urol. 1993; 24: 214-221
        • Gerstenberg T.C.
        • Nordling J.
        • Hald T.
        • et al.
        Standardized evaluation of erectile dysfunction in 95 consecutive patients.
        J Urol. 1989; 141: 857-861
        • Golenhofen K.
        • Hannappel J.
        Normal spontaneous activity of pyeloureteral system in guinea-pig.
        Pflugers Arch. 1973; 341: 257-264
        • Hauck E.
        • Schlote N.
        • Kellner B.
        • et al.
        Computergestützte Auswertung des glattmuskulären Elektromyogramms der Corpora cavernosa (CC-EMG) mittels Fast Fourier Tranformation (FFT).
        Akt Urol. 1996; 27: 291
        • Herrman W.M.
        • Fichte K.
        • Kubicki S.
        Mathematische Relationale für die klinischen EEG-Frequenzbänder. 1. Faktorenanalyse mit EEG-Powerspektralschätzungen zur Definition von Frequenzbändern.
        EEG-EMG. 1978; 9: 146
        • Höppner C.K.
        • Stief C.G.
        • Jonas U.
        • et al.
        Electrical and chemical control of smooth muscle activity of rabbit corpus cavernosum in vitro.
        Urology. 1996; 48: 512-518
        • Höppner C.
        • Stief C.G.
        • Jonas U.
        • et al.
        Rabbit penile corpus cavernosum: Electrical and mechanical activity of isolated strips..
        in: Investigative Urology V. Chapman and Hall, Weinheim, New York1994: 189
        • Jünemann K.P.
        • Bührle C.P.
        • Stief C.G.
        Current trends in corpus cavernosum EMG: Conclusions of the First International Workshop on Smooth Muscle EMG Recordings/Leiomyogram, April 15 to 17, 1993, Mannheim, Germany.
        Int J Impot Res. 1993; 5: 105-111
        • Kellner B.
        • Stief C.G.
        • Hinrichs H.
        • et al.
        Application of factor analysis for the determination of specific frequency bands in corpus cavernosum EMG power density spectra.
        Urol Res. 1996; 24: 313
        • Kitamura K.
        • Suzuki H.
        • Ito Y.
        • et al.
        Similarity and diversity of electrical activity in vascular smooth muscles.
        Prog Clin Biol Res. 1990; 327: 257-266
        • Kondo T.
        • Tamura K.
        • Onoe K.
        • et al.
        In vivo recording of electrical activity of canine tracheal smooth muscle.
        Appl Physiol. 1992; 72: 135-144
        • Konture J.W.
        • Scott G.W.
        • Kingma Y.J.
        Electrical activity of canine gallbladder.
        J Physiol Pharmacol. 1991; 42: 85-92
        • Merckx L.
        • Schmedding E.
        • de Bruyne R.
        • et al.
        Penile electromyography in the diagnosis of impotence.
        Eur Urol. 1994; 25: 124-130
        • Moreno A.P.
        • Campos de Carvalho A.C.
        • Christ G.
        • et al.
        Gap junctions between human corpus cavernosum smooth muscle cells: Gating properties and unitary conductance.
        Am J Physiol. 1993; 264: C80-C86
        • Noack T.H.
        • Lammel E.
        • Niederste-Hollenberg A.
        • et al.
        Spontaneous depolarizations in single smooth muscle cells from rabbit penile corpus cavernosum.
        Pflügers Arch. 1993; 422: R81
        • Renzetti M.L.
        • Wang M.B.
        • Ryan J.P.
        Electrical slow-wave activity from the circular layer of cat terminal antrum.
        Am J Physiol. 1991; 261: G78-G89
        • Riezzo G.
        • Maselli M.A.
        • Pezzolla F.
        • et al.
        In vitro electro-mechanical activity of the human colon: Simultaneous recording of the electrical patterns of the two muscle layers.
        Arch Int Physiol Biochim Biophys. 1992; 100: 93-109
        • Ruegg J.C.
        Muskel..
        in: Physiologie des Menschen. Springer, Heidelberg1995: 67-87
        • Somlyo A.P.
        • Somlyo A.V.
        Signal transduction and regulation in smooth muscle.
        Nature. 1994; 372: 231-236
        • Stief C.G.
        • Djamilian M.
        • Schaebsdau F.
        • et al.
        Single potential analysis of cavernous electrical activity—a possible diagnosis of autonomic impotence?.
        World J Urol. 1990; 8: 75-81
        • Stief C.G.
        • Jünemann K.P.
        • Kellner B.
        • et al.
        Consensus and progress in corpus cavernosum-EMG.
        Int J Impot Res. 1994; 6: 177-183
        • Stief C.G.
        • Kellner B.
        • Hartung C.
        • et al.
        Computer-assisted evaluation of the smooth-muscle electromyogram of the corpora cavernosa by fast Fourier transformation.
        Eur Urol. 1997; 31: 329
        • Wagner G.
        Electrical and mechanical activity in myometrial grafts in the rabbit.
        Acta Physiol Scand. 1969; 76: 1A-9A
        • Wagner G.
        • Gerstenberg T.
        Human in vivo studies of electrical activity of corpus cavernosum.
        J Urol. 1988; 139: 327A
        • Wagner G.
        • Gerstenberg T.
        • Levin R.J.
        Electrical activity of corpus cavernosum during flaccidity and erection of the human penis: A new diagnostic method?.
        J Urol. 1989; 142: 723-727
        • Walsh M.P.
        Regulation of vascular smooth muscle.
        Can J Physiol Pharmacol. 1993; 72: 919-936
        • Ward S.M.
        • Keller R.G.
        • Sanders K.M.
        Structure and organization of electrical activity of canine distal colon.
        Am J Physiol. 1991; 260: G724-G731
        • Zell A.
        Simulation Neuronaler Netze. Addison-Wesley, Bonn1994