Bulbocavernosus Reflex
Other Names
- Bulbocavernosus Reflex
- BCR
- Bulbospongiosus Reflex (BSR)
- Osinski reflex
Purpose
- Physical exam finding to evaluate for spinal shock or spinal cord injuries
Description
- Examiner uses one hand to palpate anal sphincter
- Second hand squeezes glans penis or clitorus
- Can alternatively tug on foley catheter to stimulate reflex
- Positive test
- anal sphincter contraction with squeezing of glans penis or clitorus
Pathology
Evidence
- Niu et al: test was more sensitive than nerve conduction studies in the diagnosis of pudendal nerve injury in female patients with diabetic neurogenic bladder[3]
- Exact number not provided
Distinguishing multiple system atrophy (MSA) from Parkinson’s disease (PD)
- Niu et al: high sensitivity for MSA and high specificity in healthy controls[4]
- BCR abnormality rate was 90.9% in MSA and 0% in controls
- Lee et al: the absence of the electrically induced BCR (E-BCR) was strongly predictive of poor bladder recovery, indicating high negative predictive value[5]
- Sensitivity and specificity not reported
Intraoperative Evaluation
- Skinner et al: 94% baseline BCR acquisition rate was reported, reflecting high sensitivity for detecting intact sacral reflex pathways, but specificity was not quantified[6]
See Also
References
- ↑ Kirshblum, Steven, and Fatma Eren. "Anal reflex versus bulbocavernosus reflex in evaluation of patients with spinal cord injury." Spinal cord series and cases 6.1 (2020): 2.
- ↑ Hwang, Hyeoncheol, et al. "Optimal stimulation parameters for intraoperative bulbocavernosus reflex in infants." Journal of Neurosurgery: Pediatrics 20.5 (2017): 464-470.
- ↑ Niu, Xiaoting, et al. "Bulbocavernosus reflex test for diagnosis of pudendal nerve injury in female patients with diabetic neurogenic bladder." Aging and disease 7.6 (2016): 715.
- ↑ Niu, Xiaoting, et al. "Application of bulbocavernosus reflex combined with anal sphincter electromyography in the diagnosis of MSA and PD." International Journal of Neuroscience 132.9 (2022): 851-856.
- ↑ Lee, Dong Gyu, Sang Gyu Kwak, and Min Cheol Chang. "Prediction of the outcome of bladder dysfunction based on electrically induced reflex findings in patients with cauda equina syndrome: a retrospective study." Medicine 96.21 (2017): e7014.
- ↑ Skinner, Stanley A., and David B. Vodušek. "Intraoperative recording of the bulbocavernosus reflex." Journal of Clinical Neurophysiology 31.4 (2014): 313-322.
Created by:
John Kiel on 25 May 2020 00:27:48
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Last edited:
17 August 2025 21:52:08
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