Summary
The urinary bladder is equipped with a reflex system including cold receptors of the bladder wall and having reflex pathways partly separate from the normal micturition reflex. The ice-water test involves cooling of the bladder wall with ice-cold saline solution. In the neurologically intact adult the test is negative. A positive test indicates overt or occult neuropathy. In this report, examples are given of patients presenting with bladder symptoms and a positive test but initially lacking signs of a neurological condition. During follow-up, various neurogenic diseases appeared. It is suggested that a positive icewater test may represent a negative prognostic urodynamic sign along with a potential risk for neurogenic disease to come.
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References
Bors EH, Blinn KA (1957) Spinal reflex activity from the vesical mucosa in paraplegic patients. Arch Neurol Psychiatry 78:339–354
Fall M, Lindström S (1991) Electrical stimulation, a physiologic approach to the treatment of urinary incontinence. Urol Clin North Am 18:393–407
Fall M, Ohlsson B, Carlsson CA (1989) The neurogenic overactive bladder: classification based on urodynamics. Br J Urol 64:368–373
Fall M, Lindström S, Mazières L (1990) A bladder to bladder colling reflex in the cat. J Physiol (Lond) 427:281–300
Geirsson G (1993) Evidence of cold receptors in the human urinary bladder: effect of menthol on the bladder cooling reflex. J Urol 150:427–430
Geirsson G, Fall M, Lindström S (1993) Cystometric classification of bladder overactivity: assessment of a new system in 501 patients. Int Urogynecol J 4:186–193
Geirsson G, Lindström S, Fall M (1993) The “bladder cooling reflex” in man — characteristics and sensitivity to temperature. Br J Urol 71:675–680
Geirsson G, Gladh G, Fall M, Lindström S, Hermansson G, Hjälmås K (1994) Positive bladder cooling test in neurologically normal young children. J Urol 151:446–448
Geirsson G, Lindström S, Fall M (1994) Pressure, volume and infusion speed criteria for the ice-water test. Br J Urol 73:498–503
Hellström PA, Tammela TLJ, Kontturi MJ, Lukkarinen OA (1991) The bladder cooling test for urodynamic assessment: analysis of 400 patients. Br J Urol 67:275–279
Kidata S, Ikey Y, Hasui Y, Nishi S, Yamaguchi T, Osada Y (1992) Bladder function in elderly men with subclinical brain magnetic resonance imaging lesions. J Urol 147:1507–1509
Lindström S, Mazières L (1991) Effect of menthol on the bladder cooling reflex in cat. Acta Physiol Scand 141:1
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Fall, M., Geirsson, G. Positive ice-water test: a predictor of neurological disease?. World J Urol 14, S51–S54 (1996). https://doi.org/10.1007/BF00182066
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DOI: https://doi.org/10.1007/BF00182066