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Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Latissimus dorsi detrusor myoplasty for bladder acontractility: a systematic review

  • Forte, Antonio Jorge (Division of Plastic Surgery, Mayo Clinic) ;
  • Boczar, Daniel (Division of Plastic Surgery, Mayo Clinic) ;
  • Huayllani, Maria Tereza (Division of Plastic Surgery, Mayo Clinic) ;
  • Moran, Steven (Division of Plastic Surgery, Mayo Clinic) ;
  • Okanlami, Oluwaferanmi O. (Departments of Family Medicine and Physical Medicine & Rehabilitation, University of Michigan) ;
  • Ninkovic, Milomir (Department of Plastic, Reconstructive, Hand and Burn Surgery, Bogenhausen Academic Hospital) ;
  • Broer, Peter N. (Department of Plastic, Reconstructive, Hand and Burn Surgery, Bogenhausen Academic Hospital)
  • Received : 2021.03.05
  • Accepted : 2021.05.27
  • Published : 2021.09.15
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Abstract

Bladder acontractility affects several thousand patients in the United States, but the available therapies are limited. Latissimus dorsi detrusor myoplasty (LDDM) is a therapeutic option that allows patients with bladder acontractility to void voluntarily. Our goal was to conduct a systematic review of the literature to determine whether LDDM is a better option than clean intermittent catheterization (CIC) (standard treatment) in patients with bladder acontractility. On January 17, 2020, we conducted a systematic review of the PubMed/MEDLINE, Cochrane Clinical Answers, Cochrane Central Register of Controlled Trials, Embase, and ClinicalTrials.gov databases, without time frame limitations, to identify articles on the use of LDDM for bladder acontractility. Of 75 potential articles, 4 fulfilled the eligibility criteria. The use of LDDM to treat patients with bladder acontractility was reported in four case series by the same group in Europe. Fifty-eight patients were included, and no comparison groups were included. The most common cause of bladder acontractility was spinal cord injury (n=36). The mean (±standard deviation) operative time was 536 (±22) minutes, postoperative length of hospital stay ranged from 10 to 13 days, and follow-up ranged from 9 to 68 months. Most patients had complete response, were able to void voluntarily, and had post-void residual volume less than 100 mL. Although promising outcomes have been obtained, evidence is still weak regarding whether LDDM is better than CIC to avoid impairment of the urinary tract among patients with bladder acontractility. Further prospective studies with control groups are necessary.

Keywords

Acknowledgement

This study was supported in part by the Mayo Clinic Center for Individualized Medicine, the Mayo Clinic Center for Regenerative Medicine and the Plastic Surgery Foundation.

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