The cremasteric reflex is a superficial reflex in males in which stroking the skin of the upper inner thigh makes the cremaster muscle contract and lift the testis on the same side. It tests the L1 and L2 segments. The genital branch of the genitofemoral nerve supplies the muscle.
| Nerve root | L1-L2 |
|---|---|
| Area | Skin of the upper inner thigh |
| How to test | The examiner lightly strokes the upper inner thigh downward and watches for upward movement of the testis on the same side. |
| Muscles | |
| Nerve Supply | Genitofemoral nerve (genital branch, motor); Ilioinguinal nerve and femoral branch of genitofemoral nerve (sensory) |
Raises the testis toward the body in response to touch, helping to protect it and regulate its temperature.
An absent cremasteric reflex on the painful side is a classic sign of testicular torsion, while it is usually preserved in epididymitis, though neither finding is absolute. It can also be lost with upper motor neuron lesions or L1-L2 root and nerve damage, and may be weak in healthy older men.
Twisting of the spermatic cord cutting off blood supply to the testis; an absent cremasteric reflex supports the diagnosis and the condition is a surgical emergency.
Damage at L1-L2 abolishes the reflex on the affected side.
Damage during hernia repair can abolish the reflex and cause groin pain or numbness.
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