[The carbachol test on the determination of detrusor denervation following extended hysterectomy].

Following radical hysterectomy the urinary bladder develops a denervation supersensitivity to cholinergic stimulation. The carbachol-test based on that observation: after filling the bladder with 100 ml sterile saline and subcutaneous administration of 0,004 mg.kg-1 body weight carbachol the course of the intravesical pressure was recorded. Normal bladders respond with a pressure rise non exceeding 15 cm H2O. Between 15 and 20 cm H2O is a suspicous zone. Test results of more than 20 cm H2O indicate a denervated bladder with increasing certainty. 6 healthy women and 50 patients underwent radical hysterectomy were examined. In 20 women measurements before and after the operation were performed. The carbachol-test is semiquantitative only. In patients with bladder dysfunction we found predominant pathological test results. But there is no evident correlation between the level of the test result and the clinical degree of the micturition disturbances. In some cases the effects of the detrusor supersensitivity on the urethra and the ureter were examined. The conditions of the denervated bladder call for caution in the administration of cholinergic drugs.