Neurophysiological Testing After Prostatectomy and Urinary Diversion

Pelvic surgery may be associated with urinary incontinence and sexual disturbances, which are usually assessed subjectively through questionnaires. In contrast, neurophysiological testing may offer a series of methods to measure and assess the nervous system function after pelvic surgery, which are rarely considered. The scope of this chapter is to present the basics of neurophysiological testing and report the evidence about its use after pelvic surgery, like RP and UD. Neurophysiological tests may confirm findings on physical examination (e.g., bulbocavernosus reflex, voluntary contraction, relaxation), establish the possible functional correlates of perineal dysfunction, assess the type of fibers involved, and measure the severity of nervous system involvement. This information may provide some prognostic clues as regards the likelihood of recovery and the type of therapeutic intervention each time indicated (i.e., pharmacological treatment, physical therapy, sacral neuromodulation, urethral sling, or artificial urinary sphincter). Unfortunately, only few studies have been reported till now. Considering the primordiality of this research field, the authors want to highlight the potentials and the gaps to fill with future studies in the future.