Reflexes of the external urethral sphincter in children

Area of Science:

• Neuroscience
• Pediatric Urology
• Physiology

Background:

• The external urethral sphincter's electromyographic responses are crucial for understanding urinary continence.
• Pediatric populations with urinary tract infections or spinal cord lesions present unique challenges in sphincter control.

Purpose of the Study:

• To analyze electromyographic responses in the pediatric external urethral sphincter.
• To investigate responses to pudendal nerve electrical stimulation and external sphincter stretch.
• To compare responses in children with recurrent urinary tract infections and spinal cord lesions.

Main Methods:

• Electromyography was used to record external urethral sphincter responses.
• Electrical stimulation of the pudendal nerve was performed.
• Mechanical stretch of the external sphincter was applied.
• Analysis included pediatric patients with recurrent urinary tract infections and spinal cord injuries.

Main Results:

• Electrical stimulation of the pudendal nerve elicited reflex responses mediated in the sacral spinal cord.
• These responses often presented with two distinct, individually characterizable components, similar to a flexor reflex.
• Mechanical stretch of the external sphincter produced responses comparable to those from electrical stimulation.

Conclusions:

• The external urethral sphincter exhibits reflex responses to both pudendal nerve stimulation and mechanical stretch.
• These reflexes are mediated via the sacral spinal cord.
• The findings suggest potential insights into sphincter dysfunction in pediatric populations.