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Positive bladder cooling test in neurologically normal young children
G Geirsson1, S Lindström, M Fall
1Department of Surgery, Sahlgrenska Hospital, Göteborg, Sweden.
Insights
The bladder cooling test, a urodynamic investigation, is a positive infant reflex in children under 4 years old. This reflex is suppressed by central nervous system maturation in older children.
Area of Science:
- Pediatric Urology
- Neuro-urology
- Developmental Physiology
Background:
- The bladder cooling test is a diagnostic tool for lower urinary tract disorders.
- Understanding the developmental changes in bladder reflexes is crucial for pediatric urology.
Purpose of the Study:
- To investigate the bladder cooling test's utility in neurologically intact children.
- To determine the age-related changes and significance of a positive bladder cooling test.
Main Methods:
- The bladder cooling test was performed on 50 neurologically intact infants and children aged 6 months to 13 years.
- The test involved rapid infusion of cold saline (0-8°C) into the bladder with simultaneous pressure monitoring.
- A positive test was defined as a sustained reflex detrusor contraction similar in magnitude to a micturition contraction.
Main Results:
- The bladder cooling test was positive in children within the first 4 years of life.
- The test was typically negative in children older than 5 years.
- A positive test indicated a sustained reflex detrusor contraction.
Conclusions:
- A positive bladder cooling test represents an infant reflex response.
- Maturation of the central nervous system, with descending inhibition from higher centers, suppresses this reflex in older children.
- This finding aids in understanding normal neurodevelopmental changes in bladder function.
Abstract:
The bladder cooling test, which consists of rapid infusion of 0 to 8C saline into the bladder with simultaneous pressure measurement, was performed in 50 neurologically intact infants and children 6 months to 13 years old. The patients were referred for urodynamic investigation because of various disorders of the lower urinary tract. A positive bladder cooling test was defined as a sustained reflex detrusor contraction of about the same magnitude as the micturition contraction. The test was positive during the first 4 years of life but typically negative in children older than 5 years. These findings indicate that a positive bladder cooling test is an infant reflex response that, with the maturation of the central nervous system, becomes suppressed by descending signals from higher centers.