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Detect, confirm, monitor, and treat urological and urodynamic issues with Sierra Summit

Cadwell is working in tandem with some of the world’s leading physicians and teaching hospitals, and leading the charge in neurodiagnostic technology capabilities. Our neurodiagnostic and surgical monitoring solutions can help provide diagnoses, treatment solutions, medical therapy, surgical therapy, prevention, and surgical guidance during reconstruction, of urological diseases, deformities, disorders, neoplasms, and injuries.

With the Sierra Summit, you can perform electromyographynerve conductionevoked potentials, ultrasound, and needle guided injections in urodynamic tests to measure nerve and muscle function. Congenital malformations, disease or injury may damage the nerves and muscles of the urinary system, and cause neurogenic bladder symptoms, including overactive bladder, urinary and fecal incontinence, urinary retention or voiding dysfunction, pelvic organ prolapse, and repeated Urinary Tract Infections (UTI). During urodynamic testing, spinal cord testing and surgeries, electrodiagnosis can be used to test spinal and pelvic nerves, including the bulbocavernosus reflex (BCR) or Osinski reflex.

Electrodiagnosis in Urology

Electrodiagnosis can help diagnose, confirm, and anatomically localize neurologic disturbances in urological cases, and may influence therapy options and preventive measures.

  • Studies with surface electrodes are helpful in diagnosis of urological sydromes and in biofeedback studies. They don’t require needle precision, and are available as skin surface and ring electrodes.
  • Needle electromyography can help diagnose neuropathy or myopathy with motor unit action potentials (MUAPs). Concentric needles and single-fiber EMG needles are used in pelvic floor neuropathy electrodiagnosis.
  • Nerve conduction may be recorded directly from a nerve or from an innervated muscle, and may be sensory or motor nerve studies. Injury to the pudedal nerve is a significant factor in urinary incontinence, and can be assessed with NCS.
  • Evoked potential from the spine can also help evaluate peripheral and central nervous system transmission. Absent responses may be indicative of injury or lipoma.
  • Patients undergoing surgery may have electrodiagnostic studies as a precursor to surgery. IONM with needle EMG may help identify vital musculature during pelvic floor surgery.

Ultrasound imaging in urology

Diagnostic ultrasound shows structure and vascularity of internal organs and soft tissues, allows targeted needle guidance, and can be used to identify focal and systemic diseases. Sierra Summit integrates ultrasound with electrodiagnostics to create comprehensive diagnoses and treatment plans. Two different ultrasound hardware options are available, with a variety of ultrasound probes.

MicrUs Ultrasound Probes

  • B Mode (B+B, 4B)
  • M Mode, B+M
  • Spacial Compound
  • B-Steer (Needle Enhancement)

Probes shown above left to right, 6-15 MHz linear, 25 mm (included); 5-12 MHz Linear, 40 mm

SmartUs Ultrasound Probes

  • B Mode (B+B, 4B)
  • M Mode, B+M
  • Spacial Compound
  • B-Steer (Needle Enhancement)
  • Doppler (CFM, PDI, DPDI)
  • Pulsed and Continuous Wave
  • Spectral Doppler
  • High Pulse
  • Repetition Frequency

Probes shown above left to right, 7.5 MHz linear, 40 mm (included); 2-5 MHz Cirvilinear, 60 mm; 7.5-15 MHz Linear, 25 mm

Electrodiagnostic testing and pelvic ultrasound can help evaluate:

  • Pudendal Neuralgia as a result of injury, tumor, activity, surgery, or childbirth
  • Pelvic floor neuropathy and muscle (PFM) disorders
  • Bulbocavernosus Reflex System (BRS)
  • (Neurogenic) Sacral Nerve Dysfunction
  • Urinary Incontinence
  • Fecal Incontinence
  • Tethered Cord Syndrome
  • Occult Spinal Dysraphism Sequence
  • MEPs with magnetic stimulators
  • Electrical Stimulation and Neuromodulation
  • Multiple Sclerosis (MS) patients often have bladder issues

Needle-guided injections in urology

Using ultrasound guidance ensures the path of the needle is clear of other structures.

  • Pudendal nerve blocks may be used to alleviate the pain of pudendal neuralgia
  • Injections of botulinum toxin into the bladder muscle is a repeatable treatment option for neurogenic bladder.
Sierra Summit EMG

Sierra Summit offers a variety of benefits for urology


  • The Synchronized Patient Database includes all studies, reports and other associated documentation
  • Real-time comparisons
  • Automatic findings composer with custom phrasing
  • Personalized QuickReport™ with custom templates

Streamlined Protocols

Our application workflow is designed to improve examination efficiency, minimize patient discomfort and provide a simple interface. Our latest SFEMG+ (Single Fiber EMG Plus) protocol gives you hands-free recording, automatic peak detection and triggering, real-time analysis with live results and normative data for standard concentric needles. You can exclude traces and refine your results in seconds.

Maximized Clinical Information

Seamlessly transition views and windows without adding time or complexity

  • Move from a standard muscle screen to a detailed investigation with a single click
  • Simple on-screen controls and settings can be changed on the fly
  • Enjoy hands-free MUP triggering, Multi-MUP analysis, turns/amplitude analysis, and real-time interference pattern analysis
  • Get immediate quantified results compared with published normals
one click display change
New Cadwell EMG cart with 12-channel Summit

This smart and flexible user interface can fit your workflow and expand your capabilities

Sierra software is designed to make sense to you, regardless of what system you learned on, and has all of the tools and features that you need.

See it how you want to

Custom views give you full control of displays, colors, tables and test protocols.

Hear it how you want to

Our highest sound quality is achieved with instantaneous signal processing, dual high quality speakers and full equalizer controls.

Use it how you want to

Customize your workflow with user-defined studies and tests that can be adjusted on the fly.

Perform urodynamics exams with the handheld StrimTroller Plus™

Control gain, sweep, run/stop, playback and volume controls exactly where you need them – right next to your electrode

  • Simple interface with programmable controls
  • Adjust angle on probes or replace with standard bar or ring electrodes
  • Precise and responsive controls in the palm of your hand
  • Store traces, adjust intensity, deliver single or multiple stimulations, and reverse polarity
  • Program three buttons how you want them: run and stop EMG acquisition, distance entries, adjust EMG gain control, store EMG snapshots, or move back

Medical conditions that may cause neurogenic bladder

  • Alzheimer’s disease
  • Birth defects of the spinal cord
  • Brain tumors or lesions
  • Cauda Equina lesions
  • Cerebral palsy
  • Diabetes
  • Movement disorders
  • Multiple Sclerosis
  • Parkinson’s disease
  • Peripheral nerve lesions
  • Spina bifida
  • Spinal cord injuries
  • Spinal cord tumors or lesions
  • Stroke
  • Trauma
Urologist reviews findings with patient

Build the system you need

  • Scalable hardware and software gives you a variety of stimulators, amplifiers, and test protocols
  • Our most advanced amplifiers offer 1 -12 channels of sophisticated filtering and noise reduction
  • Choose the test protocols you want from a standard list and optional upgrades
  • Add integrated ultrasound
  • Choose from a variety of carts, computers and monitors or provide your own
  • Configure a portable system that can be set up for testing in a matter of seconds

Improve your workflow with CadLink Information Management

  • Multiple EMR interface options include auto PDF export, HL7 ADT and ORM orders inbound and results outbound
  • Fail-safe storage and Auto Archiving
  • User management with user-specific system setup, user roles and single log-in with Active Directory integration

Learn more about CadLink.

Download flyers, get software updates, and request EMG hardware and software features

Additional EMG suggested reading list here.

Find all the EMG electrodes and accessories you need

Explore Cadwell EDX products

Sierra Summit is the ideal solution for Chemodenervation, EMG, EPs, NCS, Ultrasound, and Electrodiagnostics in Urology.

Schedule your EMG, NCS, EP and Ultrasound Demonstration 

Product availability may vary between different countries and markets. Please contact Cadwell for additional information.