Dynamic Bulbocavernosus Reflex: Dyssynergia Evaluation Following SCI |
| |
Authors: | James S. Walter John S. Wheeler Jr. Robert B. Dunn |
| |
Affiliation: | 1. Micturition Dysfunction Laboratory Hines DVA Hospital Rehabilitation R&2. D Center (151L) P.O. Box 20 Hines, IL 60141 Tel 708/343-7200 x5805 &3. Department of Urology Loyola University Stritch School of Medicine 2160 South Flrst Avenue Maywood, IL 60 153;4. Department of Urology Loyola University Stritch School of Medicine 2160 South First Avenue Maywood, IL 60153 &5. VA Hines Hospital;6. DVA Hines Hospital Rehabilitation R&7. D Center (151L) P.O Box 20 Hines, IL 60141 &8. Loyola University Stritch School of Medicine 2160 South First Avenue Maywood, IL 60153 |
| |
Abstract: | ABSTRACTHigh urethral resistance caused by detrusor-sphincter dyssynergia (DSD) occurs following spinal cord injury (SCI) and results in poor voiding. A major pelvic floor reflex that may be involved in DSD is the bulbocavernosus reflex (BC) and evaluation of this reflex during the micturition cycle may provide additional information regarding this role. The periodic BC observed during micturition via cystometry is described as a dynamic bulbocavernosus reflex (DBC).The DBC was induced in upper motor neuron SCI patients using periodic dorsal penile nerve stimulation; the evoked reflex response was recorded with an anal sphincter pressure sensing balloon. Stimulation of 15–50 mA was applied at the base and dorsal side of the penis with surface electrodes, pulsed at a rate of 0.25 Hz. By applying the stimulation during cystometry, the BC reflex could be evaluated throughout the entire micturition cycle. Results showed that the DBC increased during bladder filling and bladder contractions. These findings indicate that an enhanced BC reflex is a major factor causing increased urethral resistance during micturition. (J Am Paraplegia Soc: 17; 140–145) |
| |
Keywords: | urethra detrusor-sphincter dyssynergia urodynamics micturition urinary bladder electrical stimulation |
|