[The bethanechol test in the diagnosis of neurogenic bladder. 60 cases]

Bethanechol denervation hypersensitivity test seems useful although sometimes disregarded, for the diagnosis of lower neurogenic bladder. Our own experience of 60 patients is presented. When the indications are good (large capacity, hypotonic bladder, clinical suspicion of lower neuron lesion) and when the interpretation is based on a right understanding of its mechanism, this test appears to be very reliable. Except in 4 cases, the difference of pressure is greater than 20 or less than 10 cm H20. Factors susceptible to interfere with its accuracy are summarized. We must admit some discrepancies between the results of this test (exploring the pelvic nerve) and the perineal EMG (exploring the pudendal nerve); this fact is illustrated here. The importance of a wide bladder neck as a radiologic sign of neurogenic bladder is also stressed.