[Anal sphincter electromyography, bulbocavernosus reflex and pudendal somatosensory evoked potentials in diagnosis of neurogenic lumbosacral lesions with disorders of bladder and large intestine emptying and erectile dysfunction].

The diagnostic value of anal sphincter electromyography (EMG), electrical bulbocavernosus reflex (BCR) and pudendal somatosensory evoked potentials (SEP) was studied in 16 male patients with disturbances of bladder function or defecation or with erectile dysfunction (ED) of at least several weeks' duration. All 16 patients had proven neurogenic disorders in the lumbosacral region. Eleven presented with bladder dysfunction, four with defecation problems, and nine with ED (some had more than one symptom). Fifteen patients had a pathological sphincter EMG, 14 patients a pathological BCR, and six patients a pathological pudendal SEP. Thus, the sphincter EMG was the most sensitive technique in the diagnosis of chronic pudendal lesions. However, pure afferent lesions cannot be detected by the sphincter EMG. In this case, the BCR, using unilateral stimulation of the dorsal nerves of the penis, provides the opportunity to distinguish between afferent and efferent lesions of the sacral reflex arc.