title: Detrusorectomy with rectus muscle hitch and backing.
abstract: OBJECTIVE
  Bladder autoaugmentation is a procedure that includes detrusoromyotomy or detrusorectomy with an aim to release intact urothelium, which then prolapses and increases bladder capacity and compliance. Covering of the prolapsed urothelium usually is done by using deepithelialized pedicled colonic or gastric patch. The authors present their first experiences with detrusorectomy using rectus muscle for hitch and backing.
  
  
  METHODS
  Between August 1999 and February 2002, autoaugmentation was performed in 19 patients (12 girls and 7 boys) aged 4 to 12 years (median, 8). All patients had a neurogenic bladder with small capacity and poor compliance. Detrusorectomy usually involves the whole upper half of the bladder to achieve regular shape of the huge prolapsed urothelium. Both rectus muscles are dissected from their anterior and posterior sheaths. Urothelium is sutured to the muscle at several points to prevent its retraction and shrinkage. This way, bladder is fixed and hanged on rectus muscles.
  
  
  RESULTS
  Follow-up was 6 to 35 months (median, 21). The new bladder capacity was increased in all patients and ranged from 190 to 411 ml (median, 313). All patients had clinical improvement and better compliance.
  
  
  CONCLUSIONS
  Detrusorectomy with rectus muscle hitch and backing is a safe and simple procedure. However, long-term results are needed to define value of this procedure.
authors: Department of Urology, University Children's Hospital, Belgrade, Yugoslavia.
authors: Sava V
authors: SV
authors: Perovic
authors: Miroslav L J
authors: ML
authors: Djordjevic
authors: Zoran K
authors: ZK
authors: Kekic
authors: Vojkan M
authors: VM
authors: Vukadinovic
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000601:surgery; D008297:Male; D009130:Muscle, Smooth / Q000601:surgery*; D017568:Rectus Abdominis / Q000601:surgery*; D013536:Suture Techniques; D014497:Urachus / Q000601:surgery; D001743:Urinary Bladder / Q000601:surgery*; D001750:Urinary Bladder, Neurogenic / Q000601:surgery; D019459:Urothelium / Q000601:surgery; D014718:Vesico-Ureteral Reflux / Q000601:surgery