Validation of the clinical bulbocavernosus reflex.

AIMS To validate the clinically obtained bulbocavernosus reflex (BCR) by comparing it to the results of clitoroanal reflex (CAR) electrodiagnostic testing. MATERIALS AND METHODS Thirty three women with detrusor overactivity underwent clinical examination and electrodiagnostic testing including evaluation of CAR latency using a Nicolet Viking IIe electrodiagnostic instrument, stimulating the paraclitoral area on each side in turn with paired stimuli while recording anal sphincter compound muscle action potentials bilaterally using surface patch electrodes. The results of clinical and electrodiagnostic testing were compared. RESULTS The BCR was clinically present on at least one side in 26 (79%) women, and thought to be clinically bilaterally absent in 7 (21%). Electrophysiologic testing revealed CARs to be at least unilaterally present in 30 (91%) patients. When the BCR was clinically present, a CAR was recorded in 92% of patients. Of the seven women with clinically absent BCR, just one had absent CARs. CONCLUSIONS In this sample of women with detrusor overactivity, the clinical BCR did not have strong correlation with the electrically obtained reflex.