THE ICE-WATER TEST IN THE DIAGNOSIS AND TREATMENT OF THE NEUROGENIC BLADDER

Objective To determine the usefulness of the ice-water test (IWT) in t he diagnosis and treatment of neurological bladder disease. Patients a nd methods The TWT was carried out in 148 patients with neuropathic bl adder dysfunction resulting from a traumatic lesion, to assist in thei r diagnosis and treatment, and in 130 patients with neuropathic bladde r dysfunction and multiple pathogenic disorders; the results of the TW T were used to classify those patients with hyperactive bladders. Resu lts The MIT was positive in 95% of patients affected by complete and i n 86% of patients with incomplete medullary lesions. The TWT in patien ts with lower motor neuron medullary lesions was always negative. The test was used diagnostically in all patients with lower and in 43% of those with upper motor neuron lesions. In the latter, it was used in 4 8% of patients as a rehabilitation method during the medullary-shock p hase to accelerate the appearance of the micturition reflex. In 9% of patients it was used to induce micturition during cystography. Conclus ion Because it is simple to perform, the IWT is a useful complement to urodynamic examinations in patients with neurological bladder disease and in patients with micturitional disorders that are otherwise diffi cult to interpret.