The bulbocavernous reflex may be used as an indicator of when any recovery from spinal injury is complete. If a patient has a spinal injury then this reflex may be absent during the initial recovery phase.
To test this reflex, there is an initial evaluation of anal sphincter tone by inserting a gloved, lubricated finger into the anus and noticing the amount of resistance felt. The bulbocavernous reflex can be tested with the finger still in the rectum. The glans penis or the clitoris is squeezed - alternatively, if appropriate, the examiner gives a gentle jerk on an indwelling catheter. This procedure will contract the external anal sphincter and bulbocavernous muscle when the S2 to S4 reflex is intact.
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