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Related Experiment Videos

Dynamic bulbocavernosus reflex: dyssynergia evaluation following SCI

J S Walter1, J S Wheeler, R B Dunn

  • 1Micturition Dysfunction Laboratory, Hines DVA Hospital, IL 60141.

The Journal of the American Paraplegia Society
|July 1, 1994
PubMed
Summary

High urethral resistance after spinal cord injury (SCI) is linked to the bulbocavernosus reflex (BC). This study found that the dynamic bulbocavernosus reflex (DBC) increases during bladder filling and contractions, contributing to poor voiding in SCI patients.

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Area of Science:

  • Urology
  • Neuroscience
  • Physiology

Background:

  • Detrusor-sphincter dyssynergia (DSD) causes high urethral resistance and poor voiding after spinal cord injury (SCI).
  • The bulbocavernosus reflex (BC) is a key pelvic floor reflex potentially involved in DSD.
  • Evaluating the BC reflex during micturition may clarify its role in DSD.

Purpose of the Study:

  • To investigate the dynamic bulbocavernosus reflex (DBC) during the micturition cycle in patients with SCI.
  • To determine the relationship between DBC activity and urethral resistance in SCI.
  • To assess the potential contribution of an enhanced BC reflex to DSD.

Main Methods:

  • The study induced the dynamic bulbocavernosus reflex (DBC) in upper motor neuron SCI patients via periodic dorsal penile nerve stimulation.

Related Experiment Videos

  • Evoked reflex responses were recorded using an anal sphincter pressure sensing balloon.
  • Stimulation (15-50 mA, 0.25 Hz) was applied during cystometry to evaluate the BC reflex throughout the micturition cycle.

    • Main Results:

    • The dynamic bulbocavernosus reflex (DBC) demonstrated increased activity during both bladder filling and bladder contractions.
    • These findings suggest a correlation between heightened BC reflex activity and increased urethral resistance.
    • The study identified an enhanced BC reflex as a significant factor contributing to poor voiding in SCI patients.

    Conclusions:

    • An enhanced bulbocavernosus reflex (BC) is a primary contributor to increased urethral resistance in spinal cord injury (SCI) patients.
    • The dynamic bulbocavernosus reflex (DBC) plays a crucial role in the pathophysiology of detrusor-sphincter dyssynergia (DSD) following SCI.
    • Understanding the DBC's role offers potential targets for managing voiding dysfunction in SCI.