The lazy bladder--appraisal of surgical reduction

Ten patients with abnormally large bladder capacity and large volumes of residual urine, but without neurologic or obstructive bladder disease, were urodynamically investigated. Detrusor contractility was defective in the male patients as compared with healthy men, but in this respect the women did not differ significantly from controls. After reductive cystoplasty with fundus invagination or detrusor duplication, detrusor efficiency did not improve but there was less residual urine and previous urinary tract infections did not recur. Strict indications for cystoplasty are recommended. The operation should preferably be limited to men with tendency to urinary tract infection or dilatation of the renal pelves. Bladder neck incision should be performed at the same operation.