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Thread: Bulbocavernosus reflex

  1. #1

    Bulbocavernosus reflex

    The bulbocavernosus reflex is said to return at the end of spinal shock. Well, mine just returned within the past three weeks, almost one year post.
    I remember the Shepherd Center being big on BCR, even basing the kind of BP they used on its presence or absence. I am not sure what to make of this whole BCR thing. It might well be that it is kind of irrelevant, other than demonstrate further sacral sparing.
    I am the queen of sacral sparing, yet my motor return is minimal. I am not even walking in braces yet.

  2. #2
    Original Clinical Article
    Early predictors of bladder recovery and urodynamics after spinal cord injury

    Patrick J. Shenot, David A. Rivas, Toyohiki Watanabe, Michael B. Chancellor *Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania
    *Correspondence to Michael B. Chancellor, University of Pittsburgh Medical Center, Kaufmen Building, Suite 801, 3471 5th Ave., Pittsburgh, PA 15213
    Keywordsspinal cord injury • urodynamic • bladder, neurogenic • incontinenceAbstractOur purpose was to determine if intact perianal (S4-5) pin sensation (PPS) and bulbocavernosus (S2-4) reflex (BCR) shortly after spinal cord injury (SCI) are predictive of bladder function recovery. Twenty-eight SCI patients (aged 18-68 years, Frankel Classification A-D, spinal injury level C4-T12), admitted within 72 hours of injury, underwent evaluation of initial PPS and BCR. The presence of intact PPS and BCR were correlated with the patient's voiding function and urodynamic evaluation results 1 year postinjury. Of the 28 patients within 72 hours of SCI, PPS was intact in 17 (60%) and absent in 11 (40%), while 15 patients (54%) demonstrated a positive BCR and 13 (46%) did not. One year after SCI, no patient with absent PPS voided unassisted, while of the 17 patients with preserved PPS, 11 (65%) were voiding spontaneously. Of these 11 patients, urodynamic evaluation revealed detrusor areflexia in 1 (9%), normal detrusor function in 2 (18%), and detrusor hyperreflexia in 8 (73%), with 3 of these 8 patients (38%) also demonstrating detrusor-sphincter dyssynergia. At 1 year postinjury, only 2 of 13 patients (15%) with an absent BCR voided spontaneously, while 9 of 15 patients (60%) with an intact BCR were able to void. Although PPS and BCR are moderately sensitive in predicting the return of spontaneous voiding, they cannot predict detrusor hyperreflexia and sphincter dyssynergia. Therefore, urodynamic study remains an essential component of initial urologic evaluation after SCI. Neurourol. Urodynam. 17:25-29, 1998. © 1998 Wiley-Liss, Inc.

  3. #3
    Junior Member
    Join Date
    Mar 2010
    New Hampshire

    Early predictors of bladder recovery and urodynamics after spinal cord injury


    Came across your referenced study. Just wondering if you have any further info to add. My son is now one year + post injury and considering botox to control bladder spasticity but not if it restricts or precludes any potential return of function. We inquired with his neuro-urologist in Boston about any predictive studies but he knew of none.

    Anyone else with experience or data on return of bladder function and suitability for botox treatment?

    L1 Asia B-C Incomplete, periodic volitional voiding, never emptying. Wicked spasticity that is unpredictable.

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