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Efficacy of intraoperative bulbocavernosus reflex monitoring for the prediction of postoperative voiding function in adult patients with lumbosacral spinal tumor

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Abstract

Lumbosacral spinal tumor surgery is associated with a relatively high risk of postoperative voiding dysfunction. This study aimed to investigate the correlation between intraoperative bulbocavernosus reflex (BCR) changes and postoperative voiding function in adult patients with lumbosacral spinal tumors. We retrospectively reviewed 63 patients who underwent intradural conus and cauda equina tumor surgeries with intraoperative BCR monitoring. We evaluated patients’ voiding functions for 6 months postoperatively. BCR was maintained in 60 patients and disappeared in 3 patients at the end of the surgery. Among the patients in whom BCR was maintained, examinations conducted at discharge and at 1- and 6-month follow-ups revealed that 7 (11.7%), 4 (6.7%), and zero (0.0%) patients experienced voiding difficulty, respectively. However, all 3 (100%) patients without BCR experienced voiding difficulty at the three corresponding follow-ups. Data analysis indicated no significant difference in voiding between the maintained and disappeared BCR groups 6-months postoperatively. The sensitivity, specificity, positive predictive, and negative predictive values of intraoperative BCR monitoring for detecting new and worsening difficulty in voiding were all 100% 6 months postoperatively. Our results shows that intraoperative BCR monitoring is a reliable predictor of voiding function following surgery in adult patients undergoing lumbosacral spinal tumor surgery. Intraoperative BCR monitoring can be useful for assessing and monitoring the integrity of the voiding function during lumbosacral spinal tumor surgery.

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Abbreviations

BCR:

Bulbocavernosus reflex

EMG:

Electromyography

MEP:

Motor evoked potential

MRI:

Magnetic resonance imaging

POUR:

Postoperative urinary retention

SSEP:

Somatosensory evoked potential

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Acknowledgements

The authors would like to express their gratitude to Professor Vedran Deletis, for his technical advice, and to the staffs of the Intraoperative Neurophysiological Monitoring Team, for technical assistance.

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Authors and Affiliations

  1. Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea

    Jongsuk Choi

  2. Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173 Beon-gil, Bundang-Gu, Seongnam-Si, Geonggi-Do, Republic of Korea

    Jun-Soon Kim & Kyung Seok Park

  3. Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea

    Seung-Jae Hyun & Ki-Jeong Kim

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  1. Jongsuk Choi
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  2. Jun-Soon Kim
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Correspondence to Kyung Seok Park.

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Study was approved by the Institutional Review Board of Seoul National University Bundang Hospital.

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The institutional review board waived the need for informed consent for this retrospective study.

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Choi, J., Kim, JS., Hyun, SJ. et al. Efficacy of intraoperative bulbocavernosus reflex monitoring for the prediction of postoperative voiding function in adult patients with lumbosacral spinal tumor. J Clin Monit Comput 36, 493–499 (2022). https://doi.org/10.1007/s10877-021-00678-0

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  • DOI: https://doi.org/10.1007/s10877-021-00678-0

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