Vesical Denervation Testing
This test is similar to urethral denervation testing in that it relies on Cannon’s hypothesis that a denervated end organ will give an exaggerated response when re-exposed to its neural transmit-ter. The test is performed to identify detrusor areflexia in cases of decentralization of the bladder. The test is performed by first obtaining a baseline cystometrogram. This is followed by the administration of 0.03 mg/kg of bethanecol chloride subcutaneously. The usual dose is 2.5 mg. Bethanecol should not be used in patients with asthma, cardiac disease or hyperthyroidism as it may induce bronchospasm, hypotension and atrial fibrillation in these patients. A second postadministration cystometrogram is done 30 min later. Alternatively, the intravesical pressure can be measured continuously after the introduction of a known amount of fluid into the bladder. Recording continues until an increase of 15 cmH2O occurs or 30 min has passed.
KeywordsChlor Hyperthyroidism Bethanechol
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