Premium
Detrusor myectomy for detrusor overactivity: a minimum 1‐year follow‐up
Author(s) -
Swami,
Feneley,
Hammonds,
Abrams
Publication year - 1998
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1046/j.1464-410x.1998.00474.x
Subject(s) - detrusor instability , medicine , urodynamic studies , detrusor muscle , urology , surgery , urinary bladder , urinary incontinence
Objective To evaluate the clinical and urodynamic outcome of partial detrusor myectomy in patients with idiopathic detrusor instability and neuropathic hyper‐reflexia. Patients and methods Seventeen patients with idiopathic detrusor instability and 10 with hyper‐reflexia and symptoms not responding to non‐surgical treatment underwent partial detrusor myectomy. The clinical and urodynamic results before and after myectomy were compared and the patient’s subjective assessment of the outcome documented. Results There was an overall improvement in 17 of 27 patients (63%) but the success rate was higher in those with idiopathic instability (12 of 17) than in those with neuropathy (five of 10). There was urodynamic evidence of reduced bladder contractility and an improvement in the storage characteristics of the bladder in most of the patients treated. Conclusions Partial detrusor myectomy is relatively simple and is associated with minimum morbidity and an acceptable success rate. The procedure alters the urodynamic behaviour of the bladder and leads to symptomatic and objective improvement, giving better results with idiopathic than with neuropathic detrusor overactivity. Detrusor myectomy may be offered to patients with detrusor overactivity unresponsive to conventional management. The option of enterocystoplasty is still open to patients with an unsuccessful outcome. However, the long‐term results and surgical variations of the technique should be evaluated further.