Evidence map›Paper›PMID 41593187›Full record

Observational studyChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2026

Assessing the utility of bulbocavernosus reflex for predicting urological outcome in children with spinal dysraphism surgery.

Amparo Saenz, Ivana Jankovic, Catherine Mann, Amy Lee, Divyseh Desai, Zubair Tahir, Dachling Pang, Dominic Thompson

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Sequential intraoperative protocol to improve bulbocavernosus reflex monitorability during pediatric spinal surgery.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026
    Article
  2. Article
  3. Reconsidering the predictive boundaries of bulbocavernosus reflex monitoring in pediatric untethering surgery.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Amparo SaenzNeurosurgery Department, Great Ormond Street Hospital, London, UK. amparo.saenz@ucl.ac.uk.ORCID 0000-0002-6675-5428
Ivana JankovicNeurophysiology Department, Great Ormond Street Hospital, London, UK.
Catherine MannNeurophysiology Department, Great Ormond Street Hospital, London, UK.
Amy LeeNeurophysiology Department, Great Ormond Street Hospital, London, UK.
Divyseh DesaiUrology Department, Great Ormond Street Hospital, London, UK.
Zubair TahirNeurosurgery Department, Great Ormond Street Hospital, London, UK.
Dachling PangNeurosurgery Department, Great Ormond Street Hospital, London, UK.
Dominic ThompsonNeurosurgery Department, Great Ormond Street Hospital, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSurgical untethering for spinal dysraphism carries the risk of neural damage affecting sphincter control. Whilst anal sphincter motor-evoked potentials (MEP) are commonly used, they assess efferent pathways and do not directly reflect bladder innervation. The bulbocavernosus reflex (BCR) evaluates both afferent and efferent components of the sacral reflex arc, potentially serving as a better intraoperative predictor of urinary function. This study aimed to (1) assess the correlation between baseline BCR and preoperative urinary continence and (2) determine whether intraoperative BCR loss predicts postoperative urinary outcomes at one year.

methodsA retrospective observational study was conducted on children (aged 4-18 years) undergoing spinal cord untethering with intraoperative BCR monitoring. Preoperative and 1-year postoperative urological assessments included continence status, clean intermittent catheterisation (CIC) dependency, recurrent urinary tract infections (UTI), post-void residual volume (PVR), and vesicoureteral reflux (VUR). Sensitivity, specificity, and predictive values were calculated for both baseline and intraoperative BCR changes relative to urological outcomes.

resultsFifty patients met the inclusion criteria. Preoperative absence of BCR correlated with preoperative incontinence with 34.5% sensitivity and 90.5% specificity. Intraoperative BCR loss predicted postoperative incontinence with 14.8% sensitivity and 82.6% specificity. CIC dependency and recurrent UTIs were unchanged postoperatively, whilst increased PVR decreased from 20 to 12%.

conclusionBaseline BCR has high specificity but limited sensitivity for preoperative continence. Intraoperative BCR loss is a specific but insensitive predictor of postoperative urinary dysfunction. Whilst BCR monitoring aids intraoperative decision-making, further studies are needed to optimise its role in predicting long-term bladder outcomes.

Indexed as

Intraoperative Neurophysiological MonitoringPostoperative ComplicationsReflexSpinal DysraphismUrinary IncontinenceAdolescentChildChild, PreschoolFemaleHumansMaleRetrospective StudiesTreatment OutcomeAssessmentBulbocavernousus reflexDysraphismNeurophysiologyNeurosurgeryOutcomesPaediatricsSpinal

Identifiers

PMID41593187
PMCPMC12847168

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.