Latissimus dorsi detrusor myoplasty to restore voiding in patients with an acontractile bladder - fact or fiction?

Multiple causes at any level between the brain and the bladder can lead to diminished voiding efficiency and bladder acontractility. Treatment options for patients with an acontractile bladder have been limited as most patients were forced to perform lifelong self-catheterization at the moment. The latissimus dorsi detrusor myoplasty (LDDM) is a recent and promising therapeutic surgical option to restore adequate bladder emptying on demand. This article critically reviews the available literature on LDDM and focuses particularly on the preoperative diagnostic evaluation and patient selection, treatment outcome and the postoperative contractility measurement.