Applications of pelvic neurophysiology testing in clinical practice

• Pelvic neurophysiology tests assess sacral somatic sensory and motor innervation. • Tests are selected based on the referring clinical question. • Evaluate suspected cauda equina injury, unexplained pelvic symptoms, unclear MRI. Pelvic neurophysiology testing uniquely provides an evaluation of the sacral S2, 3 and 4 segmental somatic innervation. Since the tests are involved and some are invasive, a clear clinical question is essential in order to tailor the tests appropriately. Results should always be interpreted in conjunction with the clinical presentation and other investigation findings. The tests provide objective quantitative evidence for nerve injury and there are specific indications where these tests become of paramount importance such as the evaluation of suspected cauda equina syndrome, suspected MSA, chronic urinary retention, pelvic pain, sexual dysfunction and situations where MRI findings are inconclusive. Neurophysiology testing is a useful adjunct to clinical examination, and adds value to the diagnostic workup of patients presenting with neuro-urological disorders.