Methodologies to elicit and record pudendal somatosensory evoked potentials in adult humans: A systematic review.

• Methods for conducting pudendal SEPs vary, and most publications do not report enough detail to replicate their protocol. • Most pudendal SEP research has been conducted in males, highlighting the paucity of pelvic neurophysiology research in females. • There is a need to develop optimal sex- and patient-specific methods to investigate all branches of the pudendal nerve. The purpose of this systematic review was to characterize methodologies reported in the literature to elicit and record pudendal somatosensory evoked potentials (SEPs) in human adults. We conducted an electronic literature search in MEDLINE, Embase, CENTRAL, and CINAHL for studies that elicited pudendal SEPs via electrical stimulation and recorded responses though electroencephalography. From included studies, we extracted methodological details of how the SEPs were evoked and recorded. 132 studies were included in our review. The majority of participants were male (n = 6742/8526, 79%). Almost all studies stimulated the dorsal nerve of penis/clitoris. Stimulus parameters varied, with most standardizing stimulus intensity to 2-4x perceptual threshold, pulse duration to 0.1–0.2 ms, and frequency to 3 Hz. The number of stimuli recorded varied by clinical population. Our results demonstrate the inconsistencies of pudendal SEP methodology in the literature, with the majority (77%) of publications not reporting enough detail to reasonably replicate their protocol. Most research to date has been conducted in males, highlighting the paucity of female pelvic neurophysiology research. We propose a Pudendal SEP Reporting Checklist for adequate reporting of pudendal SEP protocols. Optimal sex- and patient-specific methodologies to investigate all branches of the pudendal nerve need to be established. [ABSTRACT FROM AUTHOR]