What is included in the neurologic exam to evaluate overactive bladder (OAB) in children?

Updated: Apr 01, 2019
  • Author: Pamela I Ellsworth, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

A focused neurologic examination should be performed to rule out an underlying neurologic etiology. The examination includes an assessment of the following:

  • Perineal sensation
  • Perineal reflexes supplied by sacral segments S1-S4 (standing on toes, bulbocavernosus reflex)
  • Anal sphincter tone
  • Possible signs of occult lumbosacral neurospinal dysraphisms in the buttocks, legs, and feet 

The position and caliber of the urethral meatus should be inspected. The abdominal examination should include assessment for a distended bladder and a full sigmoid/descending colon (suggestive of constipation). The sacrum should be palpated to ensure that it is present and the presacral area inspected for dimples, abnormal gluteal clefts, hairy patches, and other signs of possible neurologic lesions.


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