Skip to main content
Log in

Latissimus Dorsi Detrusor Myoplasty for Neurogenic Underactivity

  • Published:
Current Bladder Dysfunction Reports Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. • Stöhrer M, Blok B, Castro-Diaz D, et al.: EAU guidelines on neurogenic lower urinary tract dysfunction. Eur Urol 2009, 56:81–88. This is an important overview of nomenclature and guidelines regarding neurogenic diseases of the lower urinary tract.

    Article  PubMed  Google Scholar 

  2. Wein AJ: Neuromuscular dysfunction of the lower urinary tract. In Campbell’s Urology. Edited by Walsh PC, Stamey TA, Vaughan ED. Philadelphia, PA: W. B. Saunders; 1992:573–642.

    Google Scholar 

  3. Madjar S, Appell RA: Impaired detrusor contractility: anything new? Curr Urol Rep 2002, 3:373–377.

    Article  PubMed  Google Scholar 

  4. Kuhn W, Rist M, Zaech GA: Intermittent urethral self-catheterization: long-term results (bacteriological evolution, continence, acceptance, complications). Paraplegia 1991, 29:222–232.

    CAS  PubMed  Google Scholar 

  5. Tanagho EA, Schmidt RA: Electrical stimulation in the clinical management of the neurogenic bladder. J Urol 1988, 140:1331–1339.

    CAS  PubMed  Google Scholar 

  6. Brindley GS, Rushton DN: Long-term follow-up of patients with sacral motor root stimulator implants. Paraplegia 1990, 28:469–475.

    CAS  PubMed  Google Scholar 

  7. Ninkovic M, Dabernig W: Flap technology for reconstructions of urogenital organs. Curr Opin Urol 2003, 13:483–488.

    Article  PubMed  Google Scholar 

  8. Chancellor MB, Rivas DA, Acosta R, et al.: Detrusor myoplasty, innervated rectus muscle transposition study, and functional effect on the spinal cord injury rat model. Neurourol Urodyn 1994, 13:547–557.

    Article  CAS  PubMed  Google Scholar 

  9. Erol A, Ozgur S, Erol U, et al.: Partial bladder reconstruction with pedicled rectus and gracilis muscle flaps: an experimental study in dogs. Br J Urol 1994, 74:775–778.

    Article  CAS  PubMed  Google Scholar 

  10. Stenzl A, Ninkovic M, Willeit J, et al.: Free neurovascular transfer of the latissimus dorsi muscle to the bladder. I. Experimental studies. J Urol 1997, 157:1103–1108.

    Article  CAS  PubMed  Google Scholar 

  11. Ninkovic M, Stenzl A, Hess M, et al.: Functional urinary bladder wall substitute using free innervated latissimus dorsi muscle flap. Plast Reconstr Surg 1997, 100:402–411.

    Article  CAS  PubMed  Google Scholar 

  12. van Heyden B, Anthony JP, Brock GB, et al.: The latissimus dorsi bladder myoplasty to assist detrusor function. Urol Res 1998, 26:215–221.

    Article  Google Scholar 

  13. Stenzl A, Ninkovic M: Restoring voluntary voiding using a latissimus dorsi muscle free flap for bladder reconstruction. Microsurgery 2001, 21:235–240.

    Article  CAS  PubMed  Google Scholar 

  14. Stenzl A, Ninkovic M, Kölle D, et al.: Restoration of voluntary emptying of the bladder by transplantation of innervated free skeletal muscle. Lancet 1998, 351:1483–1485.

    Article  CAS  PubMed  Google Scholar 

  15. Ninkovic M, Stenzl A, Schwabegger A, et al.: Free neurovascular transfer of latissimus dorsi muscle for the treatment of bladder acontractility: II. Clinical results. J Urol 2003, 169:1379–1383.

    Article  CAS  PubMed  Google Scholar 

  16. • Gakis G, van Koeveringe G, Raina S, et al.: Latissimus dorsi detrusor myoplasty in patients with acontractile bladder: long-term results of a multicenter study [abstract 95077]. Presented at the American Urological Association Annual Meeting. Chicago, IL; April 25–30, 2009. These are the first long-term results with this surgery performed in several centers worldwide.

  17. Dindo D, Demartines N, Clavien PA: Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004, 240:205–213.

    Article  PubMed  Google Scholar 

Download references

Disclosure

No potential conflicts of interest relevant to this article were reported.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Arnulf Stenzl.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gakis, G., Ninkovic, M., Sturtz, G. et al. Latissimus Dorsi Detrusor Myoplasty for Neurogenic Underactivity. Curr Bladder Dysfunct Rep 5, 98–101 (2010). https://doi.org/10.1007/s11884-010-0049-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11884-010-0049-4

Keywords

Navigation