Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time)
CPT4 code
Name of the Procedure:
Stimulus Evoked Response (Measurement of Bulbocavernosus Reflex Latency Time)
Summary
The Stimulus Evoked Response procedure, specifically for measuring the bulbocavernosus reflex latency time, is a diagnostic test that assesses the function of the nerves associated with the pelvic floor. It involves stimulating the genital area and observing the reflex contraction of the pelvic muscles.
Purpose
The procedure is primarily used to diagnose and evaluate conditions affecting the pelvic nerves and muscles. It aims to determine nerve damage or dysfunction, which can contribute to issues such as urinary incontinence, erectile dysfunction, or other pelvic disorders.
Indications
- Symptoms of pelvic nerve damage or dysfunction.
- Conditions like urinary incontinence or pelvic floor disorders.
- Erectile dysfunction in males.
- Unexplained pelvic pain or symptoms that suggest neurogenic causes.
Preparation
- No special fasting is required.
- Patients may need to adjust medication only if instructed by their healthcare provider.
- A brief clinical history and physical examination are usually conducted to determine the need for the procedure.
Procedure Description
- Initial Setup: The patient lies comfortably on an examination table.
- Stimulation: A small probe or electrode is placed on the genital area.
- Response Measurement: The electrical stimulus is delivered, and the reflex contraction of the pelvic muscles is recorded.
- Analysis: The latency time, or the time it takes for the reflex response to occur after the stimulus, is measured.
Equipment used:
- Electrodes for stimulation and recording.
- Monitoring devices to track muscle contractions and nerve activity.
Anesthesia:
- Typically, no anesthesia or sedation is required.
Duration
The procedure usually takes about 10-20 minutes.
Setting
It is commonly performed in an outpatient clinic, urology center, or neurophysiology lab.
Personnel
- A healthcare provider specializing in urology, neurology, or neurophysiology.
- Trained medical assistants or nurses to assist with the procedure.
Risks and Complications
- Common Risks: Mild discomfort or transient pain at the stimulation site.
- Rare Risks: Possible skin irritation from electrodes. Nerve injury is exceedingly rare but theoretically possible.
Benefits
- Provides valuable diagnostic information about pelvic nerve function.
- Can help tailor more effective treatment plans for pelvic floor disorders.
- Non-invasive and quick.
Recovery
- Patients can return to their regular activities immediately after the procedure.
- Minimal recovery is needed.
- Follow-up appointments may be scheduled to discuss results and next steps.
Alternatives
- Conservative Treatments: Physical therapy or lifestyle changes.
- Imaging: MRI or CT scans for structural evaluation.
- Each alternative has its own pros and cons; conservative treatments are non-invasive but may not provide detailed diagnostic information, while imaging can be expensive and less specific for nerve function assessment.
Patient Experience
- During the procedure, patients may feel mild electrical pulses and slight muscle contractions, which can be slightly uncomfortable but not usually painful.
- After the procedure, patients might experience minor soreness at the electrode sites, which generally resolves quickly.
- Ensuring patient comfort and explaining each step can help ease anxiety related to the procedure.