title: Use of the Bulbocavernosus Reflex System in assessing voiding dysfunction.
abstract: OBJECTIVE
  The Bulbocavernosus Reflex System (BRS) (Laborie, Canada) is an office-based procedure used to measure the bulbocavernosus reflex (BCR) latency period. The aim of this study is to evaluate the BCR as a predictor of specific voiding dysfunction patterns confirmed by urodynamics (UDS).
  
  
  METHODS
  A total of 87 men were evaluated with BRS, UDS, and electromyography at Weill Cornell Medical College from March to August 2010. Baseline characteristics, demographics, UDS, and latency parameters were recorded. Multivariate logistic regression analysis was performed to evaluate prolonged BCR (latency >45 ms) as a predictor of specific voiding dysfunction patterns.
  
  
  RESULTS
  The median age of men was 70.4 years (IQR 57.6-75.6). Based on UDS, 60 men were given a primary or secondary diagnosis of bladder outlet obstruction (BOO), 43 a diagnosis of detrusor overactivity (DO), 11 a diagnosis of intrinsic sphincter deficiency (ISD), and 4 a diagnosis of detrusor sphincter dyssynergia (DSD). Median BCR latency was 57.0 ms (IQR 47.5-76.5) and 68 (78%) men demonstrated a prolonged latency. In multivariate analysis, latency period was not significantly associated with DO, BOO, ISD, or DSD (p = 0.067, 0.696, 0.999, 0.971, respectively).
  
  
  CONCLUSIONS
  Prolonged bulbocavernosus reflex latency was not associated with DO, BOO, ISD, or DSD. Although evidence in the literature suggests a link between this reflex arc and voiding, its specific diagnostic role remains unclear. Large prospective trials are needed to further explore the role of BCR in the evaluation of patients with voiding dysfunction.
authors.affiliation: Department of Urology, Weill Medical College of Cornell University, New York-Presbyterian Hospital, 425 E. 61st Street, 12th Floor, New York, NY, 10065, USA.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Laudano
authors.forename: Bilal
authors.initials: B
authors.lastname: Chughtai
authors.forename: Richard K
authors.initials: RK
authors.lastname: Lee
authors.forename: Stephan
authors.initials: S
authors.lastname: Seklehner
authors.forename: Dean
authors.initials: D
authors.lastname: Elterman
authors.forename: Steven A
authors.initials: SA
authors.lastname: Kaplan
authors.forename: Alexis E
authors.initials: AE
authors.lastname: Te
mesh_terms: D000368:Aged; D001259:Ataxia / Q000175:diagnosis / Q000503:physiopathology; D003950:Diagnostic Techniques, Urological; D004576:Electromyography; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012021:Reflex, Abnormal / Q000502:physiology*; D012189:Retrospective Studies; D013997:Time Factors; D001748:Urinary Bladder Neck Obstruction / Q000175:diagnosis / Q000503:physiopathology; D053201:Urinary Bladder, Overactive / Q000175:diagnosis / Q000503:physiopathology; D014555:Urination Disorders / Q000175:diagnosis* / Q000503:physiopathology*; D014563:Urodynamics / Q000502:physiology*