Neurophysiologic studies of the sacral reflex in women with “non‐neurogenic” sacral dysfunction

Abstract

The present study supports the findings of previous studies, which reported longer sacral reflex latencies in women with "non-neurogenic" sacral dysfunction. The difference might be explained by the lower excitation level of the sacral spinal cord neurons in some women with incontinence. Women with sacral dysfunction and prolonged sacral reflex latency need to be examined neurologically and electromyographically to confirm proximal neuropathic lesion.

Utility of sphincter electromyography and sacral reflex studies in women with cauda equina lesions

“…Neurophysiologic assessment consisted of concentric needle EMG, and measurement of the clitoro‐cavernosus reflex . Standard concentric EMG needles and a commercially available EMG system (Keypoint, Natus Medical Incorporated, Alpine Biomed Neurodiagnostics, Skovlunde, Denmark) were used.…”

“…Subjects held the stimulating electrode themselves. The cathode was in contact with the clitoris, and the anode was placed 2 cm away on the labia majora . Mechanical stimulation of the clitoris was delivered by an electromechanical hammer that switched on the EMG system .…”

“…A wooden spatula pressed against the clitoris was tapped at regular intervals (∼0.5 Hz). Responses were recorded by a standard concentric EMG needle electrode inserted consecutively into the left and right bulbocavernosus muscles . To reach the bulbocavernosus muscle, the needle electrode was inserted from the lateral aspects into the posterior half of the labia majora to a depth of 1–3 cm .…”

“…Responses were recorded by a standard concentric EMG needle electrode inserted consecutively into the left and right bulbocavernosus muscles . To reach the bulbocavernosus muscle, the needle electrode was inserted from the lateral aspects into the posterior half of the labia majora to a depth of 1–3 cm . The needle electrode position was always readjusted if no reflex response could be detected following appropriate stimulation strength.…”

“…The latencies obtained for all three stimulation modalities were compared to the upper reference limit of 45 msec, established in a group of 31 women of varying parity (1–5). Their median age was 53 years (range 28–79 years) . The result of neurophysiologic measurement of the sacral reflex was graded as normal, of prolonged latency, or non‐elicitable.…”