Related Experiment Video
Updated: May 19, 2026
Detrusor Underactivity Model in Rats by Conus Medullaris Transection
Published on: August 28, 2020
Detrusor myectomy: long-term functional outcomes
Muhammad Z Aslam1, Meena Agarwal
1Department of Urology, University Hospital of Wales, Cardiff, UK. mzaslam77@yahoo.com
Insights
Detrusor myectomy provides a reasonable long-term success rate for patients with refractory detrusor overactivity. This surgical treatment improved bladder capacity and reduced involuntary contractions in over half of the patients studied.
Area of Science:
- Urology
- Surgical Procedures
Background:
- Detrusor myectomy is a surgical option for managing refractory detrusor overactivity.
- Long-term outcomes of this procedure are important for clinical decision-making.
Purpose of the Study:
- To evaluate the long-term outcomes of detrusor myectomy for refractory detrusor overactivity.
- To assess the efficacy and success rates of this surgical intervention.
Main Methods:
- A cohort of 33 patients with urodynamically proven detrusor overactivity underwent detrusor myectomy between 1995 and 2002.
- Patients included those with idiopathic and neurogenic detrusor overactivity.
- Follow-up averaged 148 months.
Main Results:
- Overall success rate was 48.5% (16/33 patients).
- Marked symptom improvement was observed in 55.5% of idiopathic and 40% of neurogenic cases.
- Mean cystometric capacity increased significantly, and mean maximum detrusor contraction amplitude decreased.
Conclusions:
- Detrusor myectomy offers a reasonable long-term success rate for treating refractory detrusor overactivity.
- The procedure can lead to significant improvements in bladder function and patient symptoms.
Objectives:
Detrusor myectomy is a recognized method of bladder augmentation for treating refractory detrusor overactivity. Herein we report the long-term outcomes of this procedure at the University Hospital of Wales in Cardiff, UK.
Methods:
Detrusor myectomy was carried out in 33 patients (7 males, 26 females) with urodynamically proven detrusor overactivity between 1995 and 2002. The mean patient age was 33 years (range 5-62). A total of 18 patients had idiopathic detrusor overactivity, whereas 15 had neurogenic detrusor overactivity.
Results:
A total of 24 patients had a detrusor myectomy alone, whereas eight patients had a detrusor myectomy with implantation of artificial urinary sphincter. One patient had detrusor myectomy with transuretero-ureterostomy. The mean follow up was 148 months (range 108-192). A total of 10 of the 18 patients with idiopathic detrusor overactivity (55.5%) and six of the 15 patients with neurogenic detrusor overactivity (40%) showed marked improvement in symptoms. Detrusor overactivity was completely abolished in 11 patients and significantly reduced in five. Postoperatively, mean cystometric capacity improved from 290 to 458 mL, whereas mean maximum amplitude of detrusor contraction was reduced from 44 cm/H(2) O to 20 cm/H(2) O. An overall success rate of 48.5% (16/33 patients) was achieved. Intermittent self catheterization was needed to achieve bladder emptying in 12 of the 16 (75%) patients. Of the remaining 17 patients who did not improve, six had CLAM enterocystoplasty carried out and two await the operation. An ileal conduit diversion and suprapubic catheter insertion was carried out in one patient each, whereas seven patients declined any further intervention.
Conclusions:
Detrusor myectomy offers a reasonable long-term success rate to patients undergoing surgical treatment for refractory detrusor overactivity.
Related Concept Videos
01:25Urinary Tract Calculi VI: Surgical Management
01:30Urinary Tract Calculi III: Medical Management
01:28Urologic Endoscopic Procedure: Cystoscopic Examination
01:22Imaging Studies VI: Voiding Cystourethrography and Cystography