• Pawan Agarwal, Shabbir Husain, Sudesh Wankhede, and D Sharma.
• Plastic Surgery Unit, Department of Surgery, NSCB Government Medical College, 292/293, Napier Town, Jabalpur, 482003, MP, India. Electronic address: drpawanagarwal@yahoo.com.
• J Plast Reconstr Aesthet Surg. 2018 May 1; 71 (5): 736-742.

BackgroundUrinary 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.MethodsWe 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).ResultsComplete 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.ConclusionRADM 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.Copyright © 2017. Published by Elsevier Ltd.

20 keywords...

hide…