Outcome of the bladder cooling test in children with nonneurogenic bladder problems
2004 (English)In: Journal of Urology, ISSN 0022-5347, E-ISSN 1527-3792, Vol. 172, no 3, 1095-1098 p.Article in journal (Refereed) Published
The bladder cooling test (BCT) engages a primitive neonatal spinal reflex that becomes suppressed by descending signals in older children and may reappear with suprasacral lesions. We assessed the outcome of the BCT in a large group of children with nonneurogenic bladder problems.
Materials and Methods:
The BCT was evaluated in a consecutive series of 178 girls and 106 boys, 1 month to 18 years old with bladder problems without overt neurology. The test was performed at the end of routine cystometry by a rapid control infusion of body warm saline followed, after fluid evacuation, by the same volume of cold saline (3 to 10C). The test was considered positive if a detrusor contraction greater than 30 cm H2O was evoked by the cold but not the warm fluid.
Most children younger than 4 years had a history of pyelonephritis (29 of 34) and/or had vesicoureteral reflux (grade IV to V in 26 of 34). For those younger than 2 years 87% of the BCTs were positive while only 21% of the tests were positive in 2 to 3-year-old children. Most children older than 4 years had idiopathic urge incontinence, and greater than 50% of the BCTs were positive in the youngest (less than 6 years) with a gradual decline to 0% at age 13 years.
Conversion of positive to negative BCTs at about age 2 years presumably represents normal maturation while positive tests in older incontinent children suggest delayed maturation of the central neuronal control of the bladder.
Place, publisher, year, edition, pages
2004. Vol. 172, no 3, 1095-1098 p.
bladder diseases, reflex, child
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-24655DOI: 10.1097/01.ju.0000135617.02742.adLocal ID: 6885OAI: oai:DiVA.org:liu-24655DiVA: diva2:244977