Ice water test in patients with overactive bladder due to cerebrovascular accidents and bladder outlet obstruction

To investigate the factors which influence the results of the ice-water test (IWT) in patients with cerebrovascular accidents or infravesical obstruction, IWT was performed on these patients with urge urinary incontinence. Thirty-two patients with cerebrovascular lesions (group 1) and 16 patients with benign prostatic hyperplasia (group 2) who demonstrated overactive detrusor function on cystometry were evaluated. Ice-chilled sterile saline was infused into the empty bladder through a balloon catheter, and detrusor pressure was simultaneously recorded. Twenty of the 32 patients (62.5%) in group 1 showed positive IWT. In the positive IWT group, threshold volume at involuntary detrusor contraction was significantly lower than that of the negative IWT group (p < 0.05). The incidence of a positive IWT appeared to be higher in patients with pontine lesions than in those with multiple cerebral infarctions. In group 2 IWT was only positive in 1 patient (6.3%). The location of cerebral lesion and the threshold volume at mechanoreceptor-induced involuntary detrusor contraction appeared to influence the results of the IWT.