J Clin Gynecol Obstet

Journal of Clinical Gynecology and Obstetrics, ISSN 1927-1271 print, 1927-128X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Gynecol Obstet and Elmer Press Inc

Journal website https://www.jcgo.org

Original Article

Volume 12, Number 2, August 2023, pages 33-38

Bulbocavernosus Reflex as an Objective Measure of Improvement Following Directed Pelvic Floor Rehabilitation for Treatment of Urinary Incontinence

Figure 1. Normal bulbocavernosus reflex latency test above with latency 33 ms. Abnormal bulbocavernosus reflex latency test below with latency 72 ms.

**Table 1.** Participant Baseline Characteristics
Characteristics	N	Min	Median	Max	Mean	SD
SD: standard deviation; UI: urinary incontinence.
Continuous measures
Age	93	18	53	96	50.9	17.07
Symptom duration	78	0.1	3.6	21	3.6	4.25
Daytime voiding frequency	78	1.5	6	17	7.3	3.50
Nighttime voiding frequency	78	0	2.5	7.5	2.2	1.47
Caffeine daily intake (mL)	70	0	355	1,538	369.7	312.30
Fluid daily intake (mL)	83	355	1,301	3,785	1,537.8	833.09
Number of accidents per day	86	0	1	8	1.5	1.81
Number of vaginal deliveries	90	0	2	5	1.6	1.28
Number of C-sections	90	0	0	3	0.3	0.61
Number of episiotomies	90	0	0	5	0.5	0.78
Categorical measures	Category	N	%
Type of pad	Diapers	7	7.4
	Face towels	1	1.1
	None	1	1.1
	Pads	4	4.2
	Panty liners	8	8.4
	Regular pads	3	3.2
	Underwear	5	5.3
Alcohol consumption	No	52	54.7
	Yes/occasionally	39	41.1
	Not reported	4	4.2
Bowel habits	Constipation	3	3.2
	Diarrhea	1	1.1
	Fecal incontinence	1	1.1
	Regular	15	15.8
	Not reported	75	78.9
Pregnant/trying to conceive	No	89	93.7
	Yes	2	2.1
	Not reported	4	4.2
Diagnoses (can be multiple)	Chronic pelvic pain	7	7.4
	Constipation	1	1.1
	Cystocele	1	1.1
	Dyspareunia	1	1.1
	Frequency of urination	37	38.9
	Incomplete bladder emptying	2	2.1
	Mixed UI	2	2.1
	Muscle spasm	1	1.1
	Pelvic pain	10	10.5
	Prolapse	5	5.3
	Rectocele	1	1.1
	Sexual dysfunction	3	3.2
	Stress UI	61	64.2
	Urge UI	28	29.5
	Urgency of urination	1	1.1
	Not reported	11	11.6

Table 1. Participant Baseline Characteristics

Characteristics

Min

Median

Max

Mean

SD: standard deviation; UI: urinary incontinence.

Continuous measures

Age

50.9

17.07

Symptom duration

0.1

3.6

4.25

Daytime voiding frequency

1.5

7.3

3.50

Nighttime voiding frequency

2.5

7.5

2.2

1.47

Caffeine daily intake (mL)

355

1,538

369.7

312.30

Fluid daily intake (mL)

355

1,301

3,785

1,537.8

833.09

Number of accidents per day

1.5

1.81

Number of vaginal deliveries

1.6

1.28

Number of C-sections

0.3

0.61

Number of episiotomies

0.5

0.78

Categorical measures

Category

Type of pad

Diapers

7.4

Face towels

1.1

None

1.1

Pads

4.2

Panty liners

8.4

Regular pads

3.2

Underwear

5.3

Alcohol consumption

54.7

Yes/occasionally

41.1

Not reported

4.2

Bowel habits

Constipation

3.2

Diarrhea

1.1

Fecal incontinence

1.1

Regular

15.8

Not reported

78.9

Pregnant/trying to conceive

93.7

Yes

2.1

Not reported

4.2

Diagnoses (can be multiple)

Chronic pelvic pain

7.4

Constipation

1.1

Cystocele

1.1

Dyspareunia

1.1

Frequency of urination

38.9

Incomplete bladder emptying

2.1

Mixed UI

2.1

Muscle spasm

1.1

Pelvic pain

10.5

Prolapse

5.3

Rectocele

1.1

Sexual dysfunction

3.2

Stress UI

64.2

Urge UI

29.5

Urgency of urination

1.1

Not reported

11.6

**Table 2.** Participant Outcome Statistics
Variable	N	Min	Median	Max	Mean	SD	t^a	P	Mean difference^b	95% bootstrap CI of difference^c
^aBased on paired t-test. Note that these results were the same statistically as the results of the nonparametric tests. ^bBased on (time 2 - time 1); a positive difference denotes an increase in score, and a negative difference denotes a decrease in score. ^cBased on 10,000 bootstrap resamples of the data. Note that intervals not containing “0” are significant. BRS: Bulbocavernosus Reflex System; CI: confidence interval; PT: post-treatment; SD: standard deviation.
BRS baseline	95	37	82	273	85.0	26.86	-16.27	< 0.001	-49.6	-58.33, -45.95
BRS PT	95	7	34	77	35.4	13.65
Manometry baseline	95	0.8	36	115.9	40.2	28.75	5.27	< 0.001	16.2	7.56, 25.58
Manometry PT	95	1.8	51.9	168.4	56.4	33.91
Number of pads Baseline	85	0	0	8	1.0	1.57	-6.12	< 0.001	-1.0	-1.34, -0.71
Number of pads PT	90	0	0	2	0.1	0.28
Number of leaks Baseline	86	0	1	9	1.8	2.17	-7.64	< 0.001	-1.8	-2.09, -1.24
Number of leaks PT	89	0	0	1	0.01	0.11
Number of treatments	95	4	8	16	8.8	2.48
Perceived improvement	95	20%	80%	100%	80%	17.79%
Level of satisfaction	26	50%	100%	100%	92.7%	12.5%

Table 2. Participant Outcome Statistics

Variable

Min

Median

Max

Mean

t^a

Mean difference^b

95% bootstrap CI of difference^c

^aBased on paired t-test. Note that these results were the same statistically as the results of the nonparametric tests. ^bBased on (time 2 - time 1); a positive difference denotes an increase in score, and a negative difference denotes a decrease in score. ^cBased on 10,000 bootstrap resamples of the data. Note that intervals not containing “0” are significant. BRS: Bulbocavernosus Reflex System; CI: confidence interval; PT: post-treatment; SD: standard deviation.

BRS baseline

273

85.0

26.86

-16.27

< 0.001

-49.6

-58.33, -45.95

BRS PT

35.4

13.65

Manometry baseline

0.8

115.9

40.2

28.75

5.27

< 0.001

16.2

7.56, 25.58

Manometry PT

1.8

51.9

168.4

56.4

33.91

Number of pads Baseline

1.0

1.57

-6.12

< 0.001

-1.0

-1.34, -0.71

Number of pads PT

0.1

0.28

Number of leaks Baseline

1.8

2.17

-7.64

< 0.001

-1.8

-2.09, -1.24

Number of leaks PT

0.01

0.11

Number of treatments

8.8

2.48

Perceived improvement

20%

80%

100%

80%

17.79%

Level of satisfaction

50%

100%

92.7%

12.5%