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Detrusor Contraction During the Ice-water-test

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01773213
Recruitment Status : Completed
First Posted : January 23, 2013
Last Update Posted : March 5, 2018
Information provided by (Responsible Party):
Thomas Kessler, Balgrist University Hospital

Brief Summary:
In this randomized, double-blind clinical trial including patients with a neurogenic lower urinary tract dysfunction undergoing urodynamic investigation at the Spinal Cord Injury Center, Balgrist University Hospital, Zürich, we aim to investigate whether the detrusor contraction during the ice-water-test is provoked by the ice water or the rapid filling.

Condition or disease Intervention/treatment Phase
Urinary Bladder, Neurogenic Neuropathic Bladder Procedure: Ice-water-test Not Applicable

Detailed Description:

The ice-water-test (IWT) was first described 1957 by Bors and Blinn and it was thought to differentiate between lesions of the upper and lower motoneuron. In cat studies, it was shown that the IWT is a C-fiber mediated lower motoneuron segmental reflex and that these unmyelinated C fibers are associated with cold receptors. This explains the positive IWT in patients with upper motoneuron lesions. In healthy humans, the IWT is positive up to the age of 4 years and becomes negative thereafter since the reflex is centrally inhibited. However, this reflex might be unmasked by a neurological disease and/or injury.

Considering that C-fibers are involved in the pathogenesis of detrusor overactivity, the IWT seems to be a useful diagnostic tool in daily practice. However, although there are many studies published on the IWT, it is unclear whether the detrusor contraction during the IWT is provoked by the ice water or whether it might be caused by the rapid filling. Therefore, we designed this randomized, double-blind trial.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 40 participants
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Basic Science
Official Title: Is the Detrusor Contraction During the Ice-water-test Provoked by the Ice Water or the Rapid Bladder Filling? A Randomized, Double-blind Clinical Trial
Study Start Date : December 2012
Actual Primary Completion Date : March 2013
Actual Study Completion Date : March 2013

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Drinking Water

Arm Intervention/treatment
Bladder dysfunction, ice-water-test Procedure: Ice-water-test
Bladder dysfunction, warm water-test Procedure: Ice-water-test

Primary Outcome Measures :
  1. Increase of detrusor pressure in cmH20 [ Time Frame: 60 minutes ]
    Increase of detrusor pressure during the verum ice-water-test and the placebo ice-water-test (intravesical pressure increase during the filling of the bladder with 4°C or 36°C water)

Secondary Outcome Measures :
  1. Sensations (yes/no) [ Time Frame: 60 minutes ]
    Coldness, Urgency, Pain, Information with yes or no

  2. Urinary incontinence [ Time Frame: 60 minutes ]
    Urinary incontinence during the test

  3. Heart rate [ Time Frame: 60 minutes ]
    Assessment of the heart rate during the test

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 90 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • neurogenic lower urinary tract dysfunction
  • urodynamic investigation
  • written informed consent
  • ≥ 18 years old

Exclusion Criteria:

  • symptomatic urinary tract infection
  • < 18 years old
  • ≥ 90 years old
  • no written informed consent
  • pregnancy

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01773213

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Neuro-Urology, Spinal Cord Injury Center & Research, Balgrist University Hospital
Zürich, Switzerland, 8008
Sponsors and Collaborators
Balgrist University Hospital

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Responsible Party: Thomas Kessler, executive physician, Balgrist University Hospital Identifier: NCT01773213    
Other Study ID Numbers: 2012-0400
First Posted: January 23, 2013    Key Record Dates
Last Update Posted: March 5, 2018
Last Verified: March 2018
Keywords provided by Thomas Kessler, Balgrist University Hospital:
Lower urinary tract
Neuropathic bladder
Overactive bladder
Additional relevant MeSH terms:
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Urinary Bladder, Neurogenic
Neurologic Manifestations
Nervous System Diseases
Urinary Bladder Diseases
Urologic Diseases
Signs and Symptoms