Journal
JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
Volume 71, Issue 5, Pages 736-742Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.bjps.2017.12.015
Keywords
Detrusor myoplasty; Bladder; Neurogenic; Spinal cord injury; Urodynamics; Rectus abdominis muscle
Categories
Ask authors/readers for more resources
Background: Urinary bladder dysfunction in the form of acontractile/hypocontractile bladder is very common after spinal cord injury and it may lead to recurrent urinary tract infection (UTI), stones formation, and deteriorating renal function. Conventionally, these patients evacuate their bladders by life-long clean intermittent catheterization (CIC) or an indwelling catheter (IC). For these patients, another option is to use innervated skeletal muscle wrap around the bladder to augment detrusor function and voluntary evacuation of bladder. Methods: We selected 5 patients with acontractile/hypocontractile bladder following spinal cord trauma. These patients were assessed by urodynamic study for post void residual volume (PVRV), detrusor pressure (Pdet), urine flow rate (Vmax), and bladder contractility index (BCI). All five patients underwent Rectus Abdominis Detrusor Myoplasty (RADM). Results: Complete spontaneous voiding was achieved in all patients. Rectus abdominis detrusor myoplasty (RADM) elicits a statistically significant reduction in PVRV and statistically significant increase in urine flow rate, bladder contractility and detrusor pressure after 6 months. Recurrent UTIs ceased in all patients. There were no immediate or late complications. Conclusion: RADM appears to be a promising option in a patient with acontractile/hypocontractile bladder to restore the bladder function. It avoids CIC in all patients leading to improvement in quality of life in select group of patients. (C) 2017 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available