Cremasteric Reflex Test

NAME OF PATHOLOGY: Cremasteric reflex test

Definition: The cremasteric reflex evaluates the presence of a pyramidal tract lesion.

Test procedure: The male patient is undressed sufficiently to expose his genitals. The cremasteric reflex can be performed either in the supine or standing positions. Using a pointed but not sharp instrument, like the handle end of a swab stick, a brisk scratch-line line is drawn in the medial aspect of the thigh very close to the testicles.

Test findings: A positive cremasteric reflex will not result in an ipsilateral contraction of the testis. This signifies an upper motor neurone in the pyramidal tracts, e.g. cauda equine syndrome, multiple sclerosis. A negative cremasteric reflex will produce ipsilateral contraction visible in the scrotum or elevation of the same testis.

Considerations: Factors affecting the cremasteric reflex include a cold environment. Also consider the possibility of an undescended testes.

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