Latissimus Dorsi Detrusor Myoplasty to Restore Voiding in Patients with an Acontractile Bladder – Fact or Fiction?

Koeveringe, Gommert van; Rademakers, Kevin; Stenzl, Arnulf

doi:10.1007/s11934-013-0349-2

Cited by 16 publications

(12 citation statements)

References 41 publications

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“…Therefore, in the right selection of patients (with at least some contractile function present on ambulatory‐UDS), this therapeutic option can be effective . Furthermore, a reconstructive surgical procedure, such as latissimus dorsi detrusor myoplasty, is only feasible in a highly selected group of patients with an acontractile bladder . This means that the majority of patients are left with no other options than carrying out life‐long CISC …”

Section: Discussionmentioning

confidence: 99%

Differentiation of lower urinary tract dysfunctions: The role of ambulatory urodynamic monitoring

et al. 2015

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Abbreviations & Acronyms CISC = clean intermitting self-catheterization DO = detrusor overactivity IDC = involuntary detrusor contraction LUTS = lower urinary tract symptoms OAB = overactive bladder SD = standard deviation UDS = urodynamic study/ studies UI = urinary incontinence UTI = urinary tract infection Objectives: To determine the value of ambulatory urodynamic monitoring in the assessment of patients with lower urinary tract symptoms. Methods: This was a cross-sectional study including patients who underwent both conventional urodynamic and ambulatory urodynamic assessment at our Center between December 2002 and February 2013. The ambulatory urodynamic studies were interpreted in a standardized way by a resident experienced with urodynamic measurements, and one staff member who specialized in incontinence and urodynamics. Results: A total of 239 patients (71 male and 168 female) were included in the present study. The largest subgroup of patients, 79 (33%), underwent ambulatory urodynamic monitoring based on suspicion of an acontractile bladder. However, 66 of these patients (83.5%) still showed contractions on ambulatory urodynamics. Other groups that were analyzed were patients with suspected storage dysfunction (47 patients), inconclusive conventional urodynamic studies (68 patients) and incontinence of unclear origin (45 patients). Particularly in this last group, ambulatory urodynamics appeared to be useful for discrimination between different causes of incontinence. Conclusions: Ambulatory urodynamic monitoring is a valuable discriminating diagnostic tool in patients with lower urinary tract symptoms who have already undergone conventional urodynamics, particularly in the case of patients with suspected bladder acontractility and incontinence of unclear origin during ambulatory urodynamics. Further study is required to determine the clinical implications of the findings and their relationship with treatment outcome.

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Section: Discussionmentioning

confidence: 99%

Differentiation of lower urinary tract dysfunctions: The role of ambulatory urodynamic monitoring

et al. 2015

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“…These approaches also have limited supporting evidence and have not demonstrated substantial effectiveness or durability of effect . Some work has been done in a small series of cases using re‐innervated latissiumus dorsi detrusor myoplasty to restore adequate bladder emptying on demand, and this approach appears to hold some promise as a surgical treatment option …”

Section: Managementmentioning

confidence: 99%

“…DU may be idiopathic in many cases, or may result from normal ageing processes, medication side-effects, or from another known cause of neurogenic, myogenic, or iatrogenic origin. 6,10,12,13 Neurogenic causes include Parkinson's disease, diabetic neuropathy, Guillane-Barre syndrome, multiple sclerosis, spinal-lumbar disk hernia or spinal cord injury, and other neuropathies 6,12,14,15 . Myogenic and circulatory factors include BOO, diabetes, heart disease, and chronic pelvic ischemia.…”

Section: Pathogenesismentioning

confidence: 99%

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Crystallizing the Definition of Underactive Bladder Syndrome, a Common but Under‐recognized Clinical Entity

Chapple

Osman

2015

LUTS

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Detrusor underactivity (DU) is an important contributor to lower urinary tract symptoms (LUTS). While DU has been defined in the literature in urodynamic terms, current definitions lack specific parameters. In addition, the clinical syndrome associated with and manifesting itself as DU, underactive bladder (UAB), has not been well defined in the literature. In the absence of a precise definition of UAB, it is difficult to appreciate the true nature and burden of this condition. We review the evidence regarding the epidemiology, pathogenesis, diagnosis, and treatment of DU and UAB and discuss the challenges in gathering data in the absence of precise definitions. DU may be idiopathic or caused by ageing, medications, or a number of causes of neurogenic, myogenic, or iatrogenic origin. Treatments are largely palliative due to a lack of curative options, and include watchful waiting, catheterization, medications, and surgical interventions. In light of the evidence available in the literature, we propose that a new symptom-based definition of UAB syndrome should be developed as a first step in furthering more standardized research. Further discussion on this proposed definition to reach expert consensus will enable researchers to gather more robust data, allowing greater insights into DU and UAB diagnosis and treatment.

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“…However, this drug has many, albeit well-tolerated, side effects [25]. Another recent and promising approach is latissimus dorsi detrusor myoplasty [26] as recovery of micturition may be possible in 70% of cases [27]. Finally, physicians have few therapeutic alternatives for patients with persistent VD and intermittent self-catheterization remains the gold standard to avoid recurrent urinary tract infections and urogenital prolapse subsequent to abdominal pushing efforts.…”

Section: Commentsmentioning

confidence: 99%

Contribution of sacral neuromodulation to manage persistent voiding dysfunction after surgery for deep infiltrating endometriosis with colorectal involvement: preliminary results

Timoh

Canlorbe

Vérollet

et al. 2015

European Journal of Obstetrics & Gynecology and Reproductiv

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Latissimus Dorsi Detrusor Myoplasty to Restore Voiding in Patients with an Acontractile Bladder – Fact or Fiction?

Cited by 16 publications

References 41 publications

Differentiation of lower urinary tract dysfunctions: The role of ambulatory urodynamic monitoring

Differentiation of lower urinary tract dysfunctions: The role of ambulatory urodynamic monitoring

Crystallizing the Definition of Underactive Bladder Syndrome, a Common but Under‐recognized Clinical Entity

Contribution of sacral neuromodulation to manage persistent voiding dysfunction after surgery for deep infiltrating endometriosis with colorectal involvement: preliminary results

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