Detrusor Myoplasty for Acontractile/Hypocontractile Bladder in Spinal Cord Injury Patients

Acontractile bladder is very common after spinal cord injury which may lead to morbidity and even renal failure. The standard treatment options to facilitate bladder emptying include clean intermittent catheterization (CIC) or indwelling catheter (IC), which is also not free of complications. The purpose of this article is to review the treatment options for acontractile bladder; especially feasibility and effectiveness of muscle wrap around urinary bladder to improve voluntary voiding. We performed Rectus Abdominis Detrusor Myoplasty (RADM) in 5 patients of acontractile bladder following spinal cord injury. Postoperatively, all 5 patients could void urine immediately after removal of per-urethral catheter after 3 weeks. After RADM, Post Void Residual Volume, Bladder Contractility Index, Detrusor Pressure and urine flow rate (V-max) improved significantly (p < 0.05) in all patients. Rectus Abdominis Detrusor Myoplasty is a promising surgical option in a patient having hypocontractile or acontractile urinary bladder. In this mini review RADM and other treatment options for acontractile bladder have been reviewed.