Evaluation of screening tests for detecting sacral autonomic neuropathy in diabetes mellitus. A preliminary study

In 6 patients with diabetes mellitus and 6 non-diabetic "controls" referred for urological assessment, sacral electromyelography (SER) and electrical stimulation of the anal reflex were compared with pressure/flow videocystourethrography (VCU) for the detection of sacral neuropathy, whilst electrocardiography (ECG) was used to screen for generalised autonomic neuropathy. Five diabetics had evidence of a neuropathic bladder on VCU and on electrical stimulation all 5 had an absent anal reflex, which may thus prove to be a simple, reliable, non-invasive screening test for sacral neuropathy.