A NEW DETRUSOR FUNCTION TEST (ISOMETRIC TEST) -A WAY TO EXAMINE THE MECHANISM OF DETRUSOR HYPERREFLEXIA

Abstract

To examine the physiological property of detrusor reflex system, a new detrusor function test, —“Isometric test”— was undertaken on 62 cases of neurogenic dysfunction of the bladder which were recognized as detrusor hyperreflexia by cystometrography.
At 80% of maximum bladder capacity, the infusion of pressure medium (saline solution) was stopped, then we compared the pattern of uninhibited contraction of detrusor before and after the stop of infusion. If uninhibited contraction disappeared or was diminished by stopping the infusion, the result was defined as “positive”.
15 cases out of the 62 showed positive findings. In these cases, it seems that detrusor hyperreflxia mainly depends upon the stretch stimulus of detrusor. On the other hand, in the negative cases, the hyperreflexia depends upon another sensory modality, bladder volume itself.
Furthermore the high incidence (84%) of positive isometric test in OPCA cases (oligoponto-cerebellar atrophy) suggested that there were a certain specific mechanism and topography which contributed to the detrusor reflex system.
On these problems, discussion was attempted.