title: The ice-water test in the diagnosis of detrusor-external sphincter dyssynergia.
abstract: The ice-water test (IWT) implies rapid intravesical infusion of 100 ml of sterile ice-water during continuous pressure measurement and registration of fluid leakage. In a typical positive test, there is fluid leakage around the catheter(s) during the peak of detrusor contraction elicited by cold stimulation. Seventy-six patients, the majority with different forms of spinal disorders and a clinical and urodynamically suspected detrusor-external sphincter dyssynergia, were subjected to cystometry, needle electromyography (EMG) and an ice-water test. Detrusor-external sphincter dyssynergia was found in 44 (59%) patients and 41 of them had a positive IWT. A positive test with a high detrusor pressure indicates detrusor-external sphincter dyssynergia whereas the contrary applies to the negative test. Eighteen patients who responded to cold stimulation with detrusor contraction but without fluid leakage, called positive non-leakage IWT, all presented detrusor-external sphincter dyssynergia according to EMG. In this situation, the cheap, non-invasive and simple IWT can replace a needle EMG study.
authors.affiliation: Dept. of Urology, Reykjavik City Hospital, Iceland.
authors.forename: G
authors.initials: G
authors.lastname: Geirsson
authors.forename: M
authors.initials: M
authors.lastname: Fall
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003080:Cold Temperature; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009046:Motor Neurons / Q000502:physiology; D009119:Muscle Contraction / Q000502:physiology; D012021:Reflex, Abnormal / Q000502:physiology; D012189:Retrospective Studies; D013118:Spinal Cord Diseases / Q000175:diagnosis / Q000503:physiopathology; D013122:Spinal Diseases / Q000175:diagnosis / Q000503:physiopathology; D014521:Urethra / Q000503:physiopathology*; D001750:Urinary Bladder, Neurogenic / Q000175:diagnosis* / Q000503:physiopathology; D014563:Urodynamics / Q000502:physiology*; D014867:Water
chemical_list: D014867:Water