Latissimus Dorsi Detrusor Myoplasty for Neurogenic Underactivity

Abstract

Patients with chronic detrusor acontractility caused by a lower motor neuron lesion typically require lifelong clean intermittent catheterization—with all its inherent long-term risks—to empty their bladder. Latissimus Dorsi Detrusor Myoplasty is a sophisticated surgical technique of free neurovascular transfer of the latissimus dorsi muscle that is anchored to osseous and fascial structures around the bladder to restore voluntary voiding. Following several experimental studies, the first report of the clinical applicability demonstrating complete restoration of voluntary voiding in three patients with bladder acontractility was reported in 1998. In 2003, the first long-term data proved the viability of the procedure. The current long-term data from a multicenter analysis underline once more the potency of successfully restoring bladder emptying in acontractile bladder via latissimus dorsi detrusor myoplasty.