Aims: To develop a nomogram with severity categories for detrusor overactivity (DO). Methods: By conducting ice water tests (IWT) in 55 patients with Parkinson’s disease, we identified criteria to describe characteristics of the detrusor pressure curves: (1) a gradient of Δpdet over Δt at the maximum detrusor pressure and (2) the area under the curve. In a nomogram, 10 severity categories of DO were established: 1 and 2 were assigned to group A (mild), 3 and 4 to group B (moderate) and 5–10 to group C (severe). Results: In the nomogram, negative IWT (20) appeared in category 1. Positive IWT (35) spread over the categories 1–8, 17 in group A, 11 in group B and 7 in categories 5–10. A relationship of incontinence episodes and nomogram category was observed. The nomogram category was reproducible in repeated IWT. Therapeutic interventions to treat DO lowered the nomogram category. Conclusion: From the relationship of detrusor pressure and time in the IWT, a nomogram with 10 severity categories of DO was developed. First observations show a relationship of nomogram category and the number of incontinence episodes, reproducibility in repeated tests and the representation of effects of therapeutic interventions to treat DO.

Keywords:
Ice water test, Bladder cooling reflex, Detrusor overactivity , Nomogram, Parkinson disease
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2018
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