Multiscale Entropy Analysis of Surface Electromyographic Signals from the Urethral Sphincter as a Prognostic Indicator for Surgical Candidates with Primary Bladder Neck Obstruction

Entropy

Hsien-Tsai Wu²  Yuan-Hong Jiang³  An-Bang Liu¹  Chun-Wei Liu²  Yu-Nian Ou²  Hann-Chorng Kuo³  Cheuk-Kwan Sun⁴ 

[1] Department of Neurology, Buddhist Tzu Chi General Hospital and Buddhist Tzu Chi University, Hualien 956, Taiwan;Department of Electrical Engineering, National Dong Hwa University, Hualien 97401, Taiwan;Department of Urology, Buddhist Tzu Chi General Hospital and Buddhist Tzu Chi University, Hualien 956, Taiwan;;Department of Emergency Medicine, E-Da Hospital, I-Shou University School of Medicine for International Students, Kaohsiung 82445, Taiwan

关键词: urodynamics;    external urethral sphincter (EUS);    electromyography (EMG);    multiscale entropy (MSE);   

DOI  :  10.3390/e17127863

来源: mdpi

【 摘 要 】

To explore information hidden in the electromyographic (EMG) signals of the urethral sphincter that may be of prognostic significance for patients with primary bladder neck obstruction (PBNO), 41 patients with voiding difficulty were divided into four groups: 1) patients with primary bladder neck obstruction (PBNO) with successful (Group 1, n = 14) and 2) unsuccessful (Group 2, n = 8) surgical outcomes, 3) patients with detrusor overactivity (Group 3, n = 7), and 4) patients with detrusor-external sphincter dyssynergia (Group 4, n = 12). All patients underwent baseline urodynamic studies (preoperative for Group 1 and Group 2) for comparison. The results demonstrated that, despite no significant difference in urodynamic parameters between Group 1 and Group 2, the large-scale multiscale entropy (MSE) of preoperative EMG (i.e., MSE_LS(EMG)) of Group 1 was significantly higher than that of Group 2 without notable difference between Group 1 and Group 3 (i.e., patients with normal sphincter function). Moreover, the MSE_LS(EMG) and small-scale MSE of preoperative EMG (i.e., MSE_SS(EMG)) of Group 2 were notably higher than those of Group 4 (i.e., patients with abnormal sphincter function), while both MSE_LS(EMG) and MSE_SS(EMG) of Group 3 were notably higher than those of Group 2. In conclusion, using MSE analysis for assessing preoperative urethral sphincter EMG signals successfully distinguished between PBNO patients with subsequent successful surgery from those with surgical failure possibly due to subtle functional impairment of the urethral sphincter that cannot be detected by routine urodynamic studies. The results, therefore, highlight the potential clinical significance of this analytical tool in guiding urologists regarding their choice of medical versus surgical treatment for this patient population.

【 授权许可】

CC BY   
© 2015 by the authors; licensee MDPI, Basel, Switzerland.