PMID- 14624918
OWN - NLM
STAT- MEDLINE
DCOM- 20031204
LR  - 20190714
IS  - 1527-9995 (Electronic)
IS  - 0090-4295 (Linking)
VI  - 62
IP  - 5
DP  - 2003 Nov
TI  - Positive response to ice water test associated with high-grade bladder outlet 
      obstruction in patients with benign prostatic hyperplasia.
PG  - 909-13
AB  - OBJECTIVES: To elucidate the clinical significance of detrusor overactivity (DO) 
      that is probably due to C-fiber activation caused by bladder outlet obstruction 
      (BOO), we examined the responses to the ice water test (IWT) in patients with 
      benign prostatic hyperplasia (BPH) and assessed the results with reference to the 
      clinical manifestations and urodynamic findings. METHODS: A total of 127 patients 
      without neurologic disease, who were older than 50 years of age, with an 
      International Prostate Symptom Score of 8 points or greater and a quality of life 
      index of 2 or more points, were enrolled in this study. We tested the response to 
      ice water instillation by monitoring the intravesical pressure in all cases and 
      assessed the results with reference to the findings of International Prostate 
      Symptom Score and quality of life index questionnaires, BOO indexes, 48-hour 
      frequency volume charts, prostate volume, and data from free-flowmetry and 
      pressure flow studies for detecting DO. Twenty patients with neurogenic bladder 
      dysfunction underwent IWT as a control group. RESULTS: The responders to the IWT 
      accounted for 14 (70%) of the 20 patients with neurogenic bladder dysfunction and 
      35 (27%) of the 127 patients without neurologic disease. All of these responders 
      showed DO on the pressure flow studies. The patients without neurologic disease 
      who responded to the IWT had higher BOO indexes than did the nonresponders and 
      had a smaller volume at a maximal desire to void on the urodynamic studies. The 
      largest single-voided volume recorded from the 48-hour frequency volume charts 
      was also smaller for the responders than for the nonresponders. CONCLUSIONS: The 
      patients with BPH clearly showed that DO was mainly due to active C-fibers 
      stimulated by high-grade BOO and that DO was a cause of urgency and 
      frequency-related symptoms with decreased bladder capacity. It will be necessary 
      to assess the inhibitory effect of capsaicin on DO caused by activation of 
      C-fibers and the reversibility of C-fiber activation after surgical treatment for 
      BPH, so that the criteria for decision-making for the treatment of BPH may be 
      clarified with the aid of the IWT.
FAU - Hirayama, Akihide
AU  - Hirayama A
AD  - Department of Urology, Nara Medical University, Kashihara, Nara, Japan.
FAU - Fujimoto, Kiyohide
AU  - Fujimoto K
FAU - Matsumoto, Yoshihiro
AU  - Matsumoto Y
FAU - Ozono, Seiichiro
AU  - Ozono S
FAU - Hirao, Yoshihiko
AU  - Hirao Y
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Urology
JT  - Urology
JID - 0366151
SB  - IM
MH  - Administration, Intravesical
MH  - Aged
MH  - *Cold Temperature
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Muscle, Smooth/innervation/physiopathology
MH  - Nerve Fibers, Unmyelinated/physiology
MH  - Nervous System Diseases/physiopathology
MH  - Nociceptors/physiology
MH  - Prostatic Hyperplasia/*complications
MH  - Urinary Bladder Neck Obstruction/etiology/*physiopathology
MH  - Urodynamics
EDAT- 2003/11/20 05:00
MHDA- 2003/12/05 05:00
CRDT- 2003/11/20 05:00
PHST- 2003/11/20 05:00 [pubmed]
PHST- 2003/12/05 05:00 [medline]
PHST- 2003/11/20 05:00 [entrez]
AID - S0090429503005880 [pii]
AID - 10.1016/s0090-4295(03)00588-0 [doi]
PST - ppublish
SO  - Urology. 2003 Nov;62(5):909-13. doi: 10.1016/s0090-4295(03)00588-0.