Genitourinary neurological exams

Follows a little summary about my favourites procedures during a genitourinary neurological exam:

BCR - bulbocavernous reflex test

Stimulus consists in a rapid pinching of the glans penis with fingers or with a spring clamp.

Some doctors elicit this reflex by firmly removing a catheter previously inserted in the urethra.

The stimulus should always come as a surprise for the patient 😶 to be effective.

It causes contraction of the bulbocavernosus muscle behind the scrotum and conseguently the rapid tightening or contraction of the

anal sphincter so the response is best palpated with a gloved finger in the rectum 😳.

In females the clitoris is stimulated but the response is more difficult to elicit and the clinical significance of its absence more dubious.

CMR - Cremasteric reflex test

It is elicited by a light stroke with the

back of the reflex hammer on the inner thigh and causes contraction of the dartos scroti muscle which contracts the scrotum and elevates the testicle.

It is a segmental reflex that evaluates L1–L2.

AR - anal reflex test

The perianal skin is lightly stroked with an applicator that elicits contraction of the anal sphincter. The segmental innervation is S5.

Penile Sensory Threshold Assessment

With a biothesiometer or vibrometer applied on the frenulum or glans penis to reach the sensory threshold.

Penile Evocated Response

More accurate neurourological investigations are performed with electrical stimulation of the dorsal penile nerves.

Penis is injected to induce a farmacological erection. Many couples of little needle electrodes are placed subdermally 😮 on the glans penis in different positions to electrically stimulate the dorsal nerves. Often this operation is performed under local anesthesia to become more tolerable. Other electrodes are placed on the penis base and a needle electrode in the perineum near the anus to detect the contraction of the anal sphincter.

I have not yet tried the last one... I read of this in a paper, a neurourology - female 😉 - doctor used this procedure on some male volunteers to map the human penis innervation.

Currently I am too afraid of the needles on the glans 😮 to try!

I would like to know if you like and/or regularly practice

some of these procedures on your patients. 😉

Sounds like fun to me.

Well, I don't think any of these tests is anything I want to have a play doctor doing to me. I can tell you that small needles inserted in the glans like those are no big deal. They are small gauge and pretty much just sub-cutaneous.

Speed

Sounds hot! I've heard of these test. The neurological is the ASIA test. That's when they are looking to see if the S1-5 are working. S means Sacral. Anal wink is the boulbouscavernosa reflex test. In Urodynamics, the Urologist performs tha test where a probe is put into the rectum and one in the penis. Does ot sound familiar?

You sound like a lot of fun. You got a webcam? If so...Well, cum into my world. We'll webcam Medical Fetish.

You can invite me to Yahoo/messenger to view cam. I will do the same.

My user name is damethatsgame@yahoo.com.

Definitely an interesting idea to spice up roleplay, perhaps I will give it a go.

The only test of that type I have had came from a female endocrinologist. She did a number of typical neural tests like having me touch my nose, hitting my knee with the little rubber hammer, etc., then she had me take off my gown. She touched the inside of my thighs with her hammer and watched my scrotum. Then she picked up my penis in one hand (she was not wearing gloves for the exam) and ran her fingernail first down the front of my penis, and then down the underside, in each case from the base to the glans. She may have done the underside twice. It tickled at first and then I started to stiffen a bit, and she stopped. I did not ask her then why she did it and she did not say, but I wondered about it later. Unfortunately, I never found out because I had no occasion to go back to her.

In play, most of this can be done safely. The BCR and Cremasteric reflex exams are fun and easy, as is the anal reflex. Penile sensation can be explored with cotton swabs, use the cotton end and the stick end to explore sensation on various areas of the body. Advanced players can use a common TENS unit to explore sensation with electricity, just be careful not to pass current through the heart or brain.

A vibrator can also be safely used to stimulate and to check sensation. If it's adjustable, you can check sensory threshold.