Aims: To investigate the association of bladder cold sensation (BCS) during the ice water test (IWT) and pain perception when botulinum toxin injections (BTI) are administered into the bladder wall. Material and Methods: In 86 patients with idiopathic overactive bladder, the BCS during the IWT was investigated. Patients were divided into 2 groups: with and without BCS. During subsequent administration of BTI, the number of perceived and painful injections as well as the pain levels on a 0-100 pain scale were compared in both groups using Student t test. Results: Thirty-five patients reported a BCS, while 51 did not. After 10 BTI, the mean number of perceived injections was 7.9 in patients with and 2.4 in patients without BCS (p < 0.0001). The mean number of painful injections was 5.4 in patients with BCS and 4.3 in patients without (p < 0.001). Mean levels on a 0-100 pain scale were 33.7 in patients with and 17.8 in patients without cold sensation (p < 0.0001). Conclusion: The association of BCS during the IWT and pain to during BTI may implicate that the perceptions of cold and pain in the urinary bladder may use similar receptors and neuronal pathways.

1.
Mazieres L, Jiang C, Lindstrom S: The C fibre reflex of the cat urinary bladder. J Physiol 1998;513 (pt 2):531-541.
2.
Geirsson G, Lindstrom S, Fall M, Gladh G, Hermansson G, Hjalmas K: Positive bladder cooling test in neurologically normal young children. J Urol 1994;151:446-448.
3.
Bors EH, Blinn KA: Spinal reflex activity from the vesical mucosa in paraplegic patients. AMA Arch Neurol Psychiatry 1957;78:339-354.
4.
Tammela TL, Hellstrom PA, Kontturi MJ: Cold sensation and bladder instability in patients with outflow obstruction due to benign prostatic hyperplasia. Br J Urol 1992;70:404-407.
5.
Petersen T, Chandiramani V, Fowler CJ: The ice-water test in detrusor hyper-reflexia and bladder instability. Br J Urol 1997;79:163-167.
6.
Deffontaines Rufin S, Jousse M, Verollet D, Guinet A, Ismael SS, Amarenco G: Cold perception of the bladder during ice water test. Study on 120 patients. Ann Phys Rehabil Med 2010;53:559-567.
7.
van Breda HM, Heesakkers JP: Botulinum toxin a in clinical practice, the technical aspects and what urologists want to know about it. Urol Int 2015;95:411-416.
8.
Hirayama A, Fujimoto K, Matsumoto Y, Ozono S, Hirao Y: Positive response to ice water test associated with high-grade bladder outlet obstruction in patients with benign prostatic hyperplasia. Urology 2003;62:909-913.
9.
Reitz A, Stohrer M, Kramer G, Del Popolo G, Chartier-Kastler E, Pannek J, Burgdorfer H, Gocking K, Madersbacher H, Schumacher S, Richter R, von Tobel J, Schurch B: European experience of 200 cases treated with botulinum-a toxin injections into the detrusor muscle for urinary incontinence due to neurogenic detrusor overactivity. Eur Urol 2004;45:510-515.
10.
Geirsson G, Lindstrom S, Fall M: The bladder cooling reflex in man - characteristics and sensitivity to temperature. Br J Urol 1993;71:675-680.
11.
Mukerji G, Yiangou Y, Corcoran SL, Selmer IS, Smith GD, Benham CD, Bountra C, Agarwal SK, Anand P: Cool and menthol receptor TRPM8 in human urinary bladder disorders and clinical correlations. BMC Urol 2006;6:6.
12.
Winchester WJ, Gore K, Glatt S, Petit W, Gardiner JC, Conlon K, Postlethwaite M, Saintot PP, Roberts S, Gosset JR, Matsuura T, Andrews MD, Glossop PA, Palmer MJ, Clear N, Collins S, Beaumont K, Reynolds DS: Inhibition of TRPM8 channels reduces pain in the cold pressor test in humans. J Pharmacol Exp Ther 2014;351:259-269.
13.
Uvin P, Franken J, Pinto S, Rietjens R, Grammet L, Deruyver Y, Alpizar YA, Talavera K, Vennekens R, Everaerts W, De Ridder D, Voets T: Essential role of transient receptor potential m8 (TRPM8) in a model of acute cold-induced urinary urgency. Eur Urol 2015;68:655-661.
14.
Mehnert U, Michels L, Zempleni MZ, Schurch B, Kollias S: The supraspinal neural correlate of bladder cold sensation - an fMRI study. Hum Brain Mapp 2011;32:835-845.
15.
Mukerji G, Waters J, Chessell IP, Bountra C, Agarwal SK, Anand P: Pain during ice water test distinguishes clinical bladder hypersensitivity from overactivity disorders. BMC Urol 2006;6:31.
16.
Wyndaele JJ, De Wachter S: The basics behind bladder pain: a review of data on lower urinary tract sensations. Int J Urol 2003;10(suppl):S49-S55.
17.
Morrison JFB: Sensations arising from the lower urinary tract; in Torrens M, Morrison JF (eds): The Physiology of the Lower Urinary Tract. Berlin, Springer-Verlag, 1987, pp 89-131.
18.
de Groat WC, Yoshimura N: Afferent nerve regulation of bladder function in health and disease. Handb Exp Pharmacol 2009;194:91-138.
19.
Habler HJ, Janig W, Koltzenburg M: Myelinated primary afferents of the sacral spinal cord responding to slow filling and distension of the cat urinary bladder. J Physiol 1993;463:449-460.
20.
Janig W, Morrison JF: Functional properties of spinal visceral afferents supplying abdominal and pelvic organs, with special emphasis on visceral nociception. Prog Brain Res 1986;67:87-114.
21.
Habler HJ, Janig W, Koltzenburg M: Activation of unmyelinated afferent fibres by mechanical stimuli and inflammation of the urinary bladder in the cat. J Physiol 1990;425:545-562.
22.
Jiang CH, Mazieres L, Lindstrom S: Cold- and menthol-sensitive C afferents of cat urinary bladder. J Physiol 2002;543(pt 1):211-220.
23.
Zagorodnyuk VP, Costa M, Brookes SJ: Major classes of sensory neurons to the urinary bladder. Auton Neurosci 2006;126-127:390-397.
24.
Wyndaele JJ, De Wachter S: The sensory bladder (1): an update on the different sensations described in the lower urinary tract and the physiological mechanisms behind them. Neurourol Urodyn 2008;27:274-278.
25.
Catterall WA: Molecular mechanisms of gating and drug block of sodium channels. Novartis Found Symp 2002;241:206-218; discussion 218-232.
26.
Aizawa N, Wyndaele JJ: Effects of phenazopyridine on rat bladder primary afferent activity, and comparison with lidocaine and acetaminophen. Neurourol Urodyn 2010;29:1445-1450.
27.
Kaneko Y, Szallasi A: Transient receptor potential (TRP) channels: a clinical perspective. Br J Pharmacol 2014;171:2474-2507.
28.
Lashinger ES, Steiginga MS, Hieble JP, Leon LA, Gardner SD, Nagilla R, Davenport EA, Hoffman BE, Laping NJ, Su X: Amtb, a TRPM8 channel blocker: evidence in rats for activity in overactive bladder and painful bladder syndrome. Am J Physiol Renal Physiol 2008;295:F803-F810.
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