[The use of the M-cholinomimetic test in predicting treatment efficacy in neurogenic bladder dysfunctions]

Presented are the first-hand correlations between therapeutic responses and hyper-response of the bladder of M-cholinomimetic drugs made by the authors on the basis of a follow-up of 98 children with hyper-reflex dysfunctions of the urinary bladder. The study revealed a definite relationship: the more pronounced hyper-response was, the more difficult it was to get a persistent effect of recovered function of the bladder. Out of 63 M-cholinomimetic-positive patients, the effective response was noted in 61.9 per cent, recovery, in 31.7 and improvement in 30.2. All of 35 cholinoceptive-negative patients (100 per cent) responded to the treatment: 77.1 per cent recovered, 22.9 per cent improved. Higher treatment response observed in cholinomimetic-negative patients could be explained by the fact that in the absence of hypersensitivity, i.e. in case of minimal "immaturity" of neuromuscular structures, it was much easier to recover the function of the bladder. And on the contrary, it was difficult to make the final prognosis for those with pronounced cholinoceptive hypersensitivity (positive tests) because of high possibility of therapeutically resistant patterns of disease. Thus, the efficacy on the treatment in children with hyper-reflex dysfunction of the urinary bladder was in inverse proportion to cholinoceptive hypersensitivity. Taking into account the currently absent methods of prognosis for therapeutic response of neurogenic dysfunctions of the urinary bladder the authors advised to use the M-cholinomimetic test for these purposes.