Rectus Abdominis Detrusor Myoplasty for Urinary Retention

N/ANot Yet RecruitingNCT07379814

University Hospitals Cleveland Medical Center50 enrolled

Overview

This investigates the outcomes of a surgical technique using the patient's own abdominal wall muscles to help contract the bladder in patients with urinary retention

This study is about a surgery called Rectus Abdominis Detrusor Myoplasty (RADM). In this surgery, a small piece of the belly muscle is moved and wrapped around your bladder to help it squeeze and empty urine. Doctors are studying this surgery because current treatments, like catheters or nerve implants, don't always work for people whose bladders don't contract on their own. This study monitors the patients' progress for a year following this surgery.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Urinary Retention Urinary Retention After Procedure Urinary Retention Postoperative

Interventions

Rectus Abdominal Detrusor MyoplastyPROCEDURE

In this surgery, the rectus abdominis muscle will be elevated and wrapped circumferentially around the bladder to augment bladder contraction in individuals with bladder acontractility or hypocontractility.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Hypo- or acontractility of the bladder documented on urodynamic testing * Injury \>1 year ago for spinal cord injury patients, no improvement in contractility with time * Failed sacral nerve stimulation implant for urinary retention treatment (If previously implanted) * Irreversible non-neurogenic bladder acontractility/hypocontractility (i.e myogenic failure after chronic obstruction, aging, frailty, idiopathic) * Undergoing RADM Exclusion Criteria: * Documented bladder outlet obstruction * Spinal cord lesion above T12 * Upper motor neuron lesion (i.e. multiple sclerosis, stroke) * Rectus diastasis, significant abdominal wall hernia, or other anatomic barrier to rectus flap harvest * Life expectancy \<10 years * Pregnant at time of surgery

Outcomes

Primary Outcomes

Change in Bladder Compliance

Bladder compliance will be calculated as the change in bladder volume divided by the change in detrusor pressure during the filling phase and reported in milliliters per centimeter of water (mL/cm H₂O).