Please wait a minute...
 Home  About the Journal Editorial Board Aims & Scope Peer Review Policy Subscription Contact us
 
Early Edition  //  Current Issue  //  Open Special Issues  //  Archives  //  Most Read  //  Most Downloaded  //  Most Cited
Aging and disease    2016, Vol. 7 Issue (6) : 715-720     DOI: 10.14336/AD.2016.0309
Original Article |
Bulbocavernosus Reflex Test for Diagnosis of Pudendal Nerve Injury in Female Patients with Diabetic Neurogenic Bladder
Niu Xiaoting, Wang Xun, Huang Huanjie, Ni Peiqi, Lin Yuanshao*, Shao Bei*
Department of Neurology, the First Affiliated Hospital, Wenzhou Medical University, Wenzhou 325000, Zhejiang, China
Download: PDF(868 KB)   HTML
Export: BibTeX | EndNote | Reference Manager | ProCite | RefWorks    
Abstract  

The study was designed to investigate the clinical application and significance of the bulbocavernosus reflex (BCR) test for diagnosing diabetic neurogenic bladder (DNB) in female subjects. In this study, 68 female patients with DNB and 40 female normal controls were subjected to a nerve conduction study (NCS) of all four limbs and the BCR test. The data were analyzed and compared, and the corresponding diagnostic sensitivities were discussed. Mean BCR latency for female DNB patients was significantly prolonged, compared to that of the control group, suggesting pudendal nerve injuries in female DNB patients. Moreover, DNB patients were categorized according to the diabetes course. Compared to that of Group A (diabetes course < 5 y), the mean BCR latency was significantly prolonged in Group B (diabetes course between 5 and 10 y) and then further prolonged in Group C (diabetes course > 10 y), which were all longer than the control group. Furthermore, compared with that of the controls, the mean BCR latency was prolonged in DNB patients with or without NCS abnormalities in limbs. Nevertheless, no significant difference was observed in BCR latency between DNB patients with and without NCS abnormalities. Significantly increasing trends were also observed in the NCS and BCR abnormality rates along with increased diabetes course. Most importantly, compared with the NCS of limbs, the BCR test was more sensitive in diagnosing DNB in the female subjects. Overall, our findings suggest that the BCR test would help to assess the pudendal nerve injury in female DNB patients, which might be a potential diagnostic tool in the clinic.

Keywords diabetic neurogenic bladder (DNB)      bulbocavernosus reflex (BCR)      nerve conduction study (NCS)      female      diagnosis     
Corresponding Authors: Lin Yuanshao,Shao Bei   
About author:

these authors contributed equally to this work.

Issue Date: 01 December 2016
Service
E-mail this article
E-mail Alert
RSS
Articles by authors
Niu Xiaoting
Wang Xun
Huang Huanjie
Ni Peiqi
Lin Yuanshao
Shao Bei
Cite this article:   
Niu Xiaoting,Wang Xun,Huang Huanjie, et al. Bulbocavernosus Reflex Test for Diagnosis of Pudendal Nerve Injury in Female Patients with Diabetic Neurogenic Bladder[J]. Aging and disease, 2016, 7(6): 715-720.
URL:  
http://www.aginganddisease.org/EN/10.14336/AD.2016.0309     OR     http://www.aginganddisease.org/EN/Y2016/V7/I6/715
Figure 1.  BCR test results on representative subjects. (A) A 50-year-old healthy woman. Stimulating electrode on the pudendal nerve and recording electrode in the left bulbocavernous muscle, with average BCR latency of 28.8ms, illustrating normal BCR. (B) A 51-year-old woman with DNB. Stimulating electrode on the pudendal nerve and recording electrode in the left bulbocavernous muscle, with average BCR latency of 62.8ms, illustrating prolonged BCR latency.
NLeft BCR latency, msRight BCR latency, msMean BCR latency, ms
Group A2150.49±6.99*51.15±6.73*51.07±6.89*
Group B2759.06±6.29*#58.63±6.17*#58.84±6.22*#
Group C2067.78±5.96*#$67.20±6.14*#$67.31±6.05*#$
Control4043.74±5.1944.44±5.3744.34±5.21
Table 1  BCR latencies in female DNB patients and control subjects.
nLeft BCR latency, msRight BCR latency, msMean BCR latency, ms
DNB patients without NCS abnormalities2657.78 ± 6.33*58.31 ± 6.96*58.04 ± 6.72*
DNB patients with NCS abnormalities4257.96 ± 6.42*#58.95 ± 6.01*#58.77 ± 6.09*#
Control4043.74 ± 5.1944.44 ± 5.3744.34 ± 5.21
Table 2  BCR latencies in DNB patients with and without NCS abnormalities.
NNCS abnormality rate, n (%)BCR abnormality rate, n (%)
Group A2110/21 (47.62%)*15/21 (71.43%)*
Group B2717/27 (62.96%)*#22/27 (81.48%)*#
Group C2015/20 (75.00%)*#$19/20 (95.00%)*#$
Control4001/40(2.50%)
Table 3  NCS and BCR abnormality rats in female DNB patients and control subjects.
[1] Yang W, Lu J, Weng J, Jia W, Ji L, Xiao J, et al (2010). Prevalence of diabetes among men and women in China. New Engl J Med, 362:1090-1101.
[2] Olapade-Olaopa EO, Morley RN, Carter CJ, WalmsleyBH (1997). Diabetic cystopathy presenting as primary acute urinary retention in a previously undiagnosed young male diabetic patient. J Diabetes Complicat, 11:350-351.
[3] Yuan Z, Tang Z, He C, Tang W (2015). Diabetic cystopathy: A review. J Diabetes, 7:442-447.
[4] Siracusano S, d′Aloia G, Lentini MG, Silvestre G (2002). Diabetic cystopathy. J Diabetes Nutr Meta, 15: 41-44.
[5] Frimodt-Moller C (1980). Diabetic cystopathy: epidemiology and related disorders. Ann Intern Med, 92:318-321.
[6] Ellenberg M (1980). Development of urinary bladder dysfunction in diabetes Mellitus. Ann Intern Med,92: 321-323.
[7] Niu XT, Shao B, Ni PQ, Wang X, Lv ZK, Zheng JH, et al (2010). Analysis of BCR and SSEP detection in female patients with urethral sphincter dysfunction. Chin J Phys Med Rehabil, 32: 691-692.
[8] Shao B, Niu XT, Ni PQ, Wang X, Chen X, Zhu BL, et al (2009). Bulbocavernosus reflex and pudendal nerve somatosensory evoked potentials performance of female peripheral neuropathy and patients with spinal cord lesions. Chin J Neurol, 42: 762-764.
[9] Shao B, Wang X, Li CL, Huang XF, Huang HB, Zheng RY, et al (2003). The cavernosus reflex assessment in the diagnosis of nerve system diseases. Chin J Neurosci, 19: 102-104.
[10] Ertekin C, Reel F (1976). Bulbocavernosus reflex in normal men and in patients with neurogenic bladder and/or impotence. J Neurol Sci, 28:1-15.
[11] Mastri AR (1980). Neuropathology of diabetic neurogenic bladder. Ann Intern Med, 92:316-318.
[12] Niu XT, Shao B, Ni PQ, Wang X, Chen X, Zhu BL, et al (2010). Bulbocavernosus reflex and pudendal nerve somatosensory-evoked potentials responses in female patients with nerve system diseases. J Clin Neurophysiol, 27:207-211.
[13] Niu XT, Shao B, Ni PQ, Wang X (2009). Electrophysiological performance of pudendal nerve in female patients with diabetes. Chin J Clin Neurosci, 17: 22-25.
[14] Shao B, Wang X, Li CL, Huang XF, Huang HB, Zheng RY, et al (2004). The evaluation of the electrophysiological determination in differential diagnosis of erective dysfunction. J Wenzhou Med Univ, 34: 420-422.
[15] Shao B, Wang X, Li CL, Huang XF, Huang HB, Zheng RY, et al (2002). The application of the cavernosus reflex and penile dorsal nerve somatosensory evoked potentials in the nervous system diseases. Chin J Neurol, 35: 388.
[16] Wang X, Shao B, Ni PQ, Li CL, Huang XF (2002). The analysis of normal value of the cavernosus reflex and penile dorsal nerve somatosensory evoked potentials. Zhejiang Med J, 24: 507-508.
[17] Ni PQ, Wang X, Niu XT, Shao B (2011). The analysis of normal value of the bulbocavernosus reflex and penile dorsal nerve somatosensory evoked potentials. J Wenzhou Med Univ, 41: 65-67.
[18] Zhang YY, Shao B, Ge DH, Ni PQ, Wang X, Wu WJ, et al (2014). The correlation between the bulbocavernosus reflex, pudendal nerve somatosensory evoked potential and sonographic urodynamic testing in patients with diabetic neurogenic bladder. Chin J Neurol, 6:58-69.
[19] Komeda Y, Kato H, Saito K, Kinoshita N, Yamazaki Y (1984). Study of bulbocavernosus reflex using electrostimulation electromyography. Hinyokika kiyo, 30:1207-1211.
[20] Rapidi CA, Karandreas N, Katsifotis C, Benroubi M, Petropoulou K, Theodorou C (2006). A combined urodynamic and electrophysiological studyof diabetic cystopathy. Neurourol Urodynam, 25: 32-38.
[21] Niu XT, Shao B, Wang X, Zhang YY, Ni PQ, Huang HY, et al (2014). The applied value of the BCR technique in diagnosis for diabetic neurogenic bladder and in the evaluation of the efficacy of drugs. J Wenzhou Med Univ, 44:12-19.
[22] You S, Wang XM, Gu MH, Tao XJ (2003). Clinical efficacy of peripheral nerve conduction velocity in diabetic patients with neurogenic bladder. Chin J Clin Rehab, 7:1779-1780.
[1] Binquan You, Bingbing Zhu, Xi Su, Feng Liu, Bingyin Wang. Gender Differences among Elderly Patients with Primary Percutaneous Coronary Intervention[J]. Aging and disease, 2018, 9(5): 852-860.
[2] Stambler Ilia. Recognizing Degenerative Aging as a Treatable Medical Condition: Methodology and Policy[J]. Aging and disease, 2017, 8(5): 583-589.
[3] Zhang Hongxia, Sun Fen, Wang Jixian, Xie Luokun, Yang Chenqi, Pan Mengxiong, Shao Bei, Yang Guo-Yuan, Yang Shao-Hua, ZhuGe Qichuan, Jin Kunlin. Combining Injectable Plasma Scaffold with Mesenchymal Stem/Stromal Cells for Repairing Infarct Cavity after Ischemic Stroke[J]. Aging and disease, 2017, 8(2): 203-214.
[4] Qian Li, Yuanshao Lin, Wensi Huang, Yulei Zhou, Xiaoli Chen, Brian Wang, Wanli Zhang, Zhengyi Cai, Jie Xue, Wenhui Zhang, Tieer Yu, Hong Wang, Jincai He, Kunlin Jin, Bei Shao. Serum IL-33 Is a Novel Diagnostic and Prognostic Biomarker in Acute Ischemic Stroke[J]. Aging and disease, 2016, 7(5): 614-622.
[5] Kosaku Komiya,Hiroshi Ishii,Jun-ichi Kadota. Healthcare-associated Pneumonia and Aspiration Pneumonia[J]. Aging and Disease, 2015, 6(1): 27-37.
[6] Tetsuro Hida,Atsushi Harada,Shiro Imagama,Naoki Ishiguro. Managing Sarcopenia and Its Related-Fractures to Improve Quality of Life in Geriatric Populations[J]. Aging and Disease, 2014, 5(4): 226-237.
[7] Paul H. Gordon. Amyotrophic Lateral Sclerosis: An update for 2013 Clinical Features, Pathophysiology, Management and Therapeutic Trials[J]. Aging and Disease, 2013, 4(5): 295-310.
[8] Lopamudra Ray,Vineet Kumar Khemka,Prajna Behera,Kausik Bandyopadhyay,Sandip Pal,Keya Pal,Debasis Basu,Sasanka Chakrabarti. Serum Homocysteine, Dehydroepiandrosterone Sulphate and Lipoprotein (a) in Alzheimer’s Disease and Vascular Dementia[J]. Aging and Disease, 2013, 4(2): 57-64.
[9] Alison Wood,Ross Runciman,Kevan R. Wylie,Ross McManus. An Update on Female Sexual Function and Dysfunction in Old Age and Its Relevance to Old Age Psychiatry[J]. Aging and Disease, 2012, 3(5): 373-384.
Viewed
Full text


Abstract

Cited

  Shared   
Copyright © 2014 Aging and Disease, All Rights Reserved.
Address: Aging and Disease Editorial Office 3400 Camp Bowie Boulevard Fort Worth, TX76106 USA
Fax: (817) 735-0408 E-mail: editorial@aginganddisease.org
Powered by Beijing Magtech Co. Ltd