New concept in bladder remodeling.
During the past five years a surgical procedure for rehabilitation of partially decompensated large-capacity bladders has been developed and utilized in 9 children and 2 adult patients. The patients presented with detrusor muscle failure. The key steps of this procedure are (1) creation of laterally-based mucosa-free detrusor pedicle flap, (2) reduction of bladder size and wrapping the flap around the body of the bladder thus doubling the muscle bulk, and (3) mobilization and extraperitonealization of the greater omentum to the reconstruction site. The indications, rationale, and surgical technique are presented. The gratifying results, as gauged by urodynamic testing, suggest that detrusor remodeling is a worthwhile procedure for a highly select group of patients.
D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D009123:Muscle Hypotonia / Q000150:complications / Q000601:surgery; D011535:Prune Belly Syndrome / Q000150:complications / Q000601:surgery; D011859:Radiography; D001743:Urinary Bladder / Q000000981:diagnostic imaging / Q000601:surgery*; D001745:Urinary Bladder Diseases / Q000209:etiology / Q000601:surgery*