ANAL-SPHINCTER EMG, BULBOCAVERNOSUS REFLE X AND PUDENDAL SEP IN THE DIAGNOSIS OF NEUROGENIC LUMBOSACRAL LESIONS ASSOCIATED WITH MICTURITIONOR DEFECATION DISTURBANCES OR ERECTILE DYSFUNCTION

The diagnostic value of anal sphincter electromyography (EMG), electri cal bulbocavernosus reflex (BCR) and pudendal somatosensory evoked pot entials (SEP) was studied in 16 male patients with disturbances of bla dder function or defecation or with erectile dysfunction (ED) of at le ast several weeks' duration. All 16 patients had proven neurogenic dis orders in the lumbosacral region. Eleven presented with bladder dysfun ction, 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 pudend al SEP. Thus, the sphincter EMG was the most sensitive technique in th e diagnosis of chronic pudendal lesions. However, pure afferent lesion s cannot be detected by the sphincter EMG. In this case, the BCR, usin g unilateral stimulation of the dorsal nerves of the penis, provides t he opportunity to distinguish between afferent and efferent lesions of the sacral reflex are.