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[Scopolamine-N-butyl bromide loaded cystometry and its clinical significance].

Exact observation of detrusor compliance is very difficult in cystometry when urination reflex is enhanced as seen in brain bladder or cord bladder. Repeated performance of cystometry in so-called hypertonic bladder often failed to reveal changes in compliance of the detrusor. Since classification of the extent of nevous factor participation in detrusor compliance in these types of bladder is expected to provide a guideline in the treatment of these cases, the present study was conducted for this purpose. Subjects and methods: The subjects were 99 cases showing so-called hypertonic, hyperreflexic, and normal bladder evaluated in cystometry. Intravesical pressure was determined before and after intravenous administration of 20 mg of the parasympathetic blocker, scopolamine-N-butylbromide (butylscopolamine bromide). Results and discussion: 1. Detrusor reflex was suppressed and detrusor compliance after elimination of parasympathetic factors was obtained after the administration of butylscopolamine bromide. 2. Cases undistinguishable as low compliance bladder from hyperreflexic bladder by conventional cystometry were demonstrated to be classified into two types after the administration of butylscopolamine bromide. 3. The volumes of the bladder at the first sensation of fullness and at maximum desire to void increased after the administration of butylscopolamine bromide. 4. Chronic effect of oral butylscopolamine bromide was found to be expected in cases showing pollakisuria or urge incontinence with remarkable increases of bladder volume at maximum desire to void and of detrusor compliance in cystmetry loaded with butylscopolamine bromide tests. 5. Cases showing no response to pharmacological denervation performed (in advance) with butylscopolamine bromide were not indicated for sacral nerve block aiming to increase bladder volume.