Experience with detrusorotomy in children by open and robotic approach



To present the author’s experience with detrusorotomy (DM) for refractory detrusor overactivity (RDO) with open and robotic approach.


Children who underwent DM for RDO in a single surgeon series since 2012 were identified from a prospectively maintained database. Those who completed the defined strict bladder cycling regime postoperatively were included in this report excluding those who failed the bladder cycling regime.


Ten children (M7: F3) were included in this report, six open and four robotic. All procedures were completed with no conversion to open in the robotic group. There were no intra or postoperative complications from the procedures. Duration of procedure was lower in robotic group (125 min) vs the open group at (208 min). Hospital stay was also lower in the robotic group (2.7 days) compared to the open group (5.6 days). All children in open group had concomitant Mitrofanoff channel created for bladder drainage. One child in robotic group had concomitant Mitrofanoff channel during DM. Median follow-up is longer at 54 months (31–82) in open group compared to 14 months (5–21). All children are clinically well with safe upper tracts on US scan in both series. Estimated % change in bladder capacity is similar in both groups at 140 (90–200) and 126 (80–200) for open and robotic groups, respectively.


DM as an extension of medical treatment for RDO can be performed safely and is effective in children. Preliminary experience with robotic approach to DM is promising with reduced duration of procedure and hospital stay.

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  1. 1.

    Biers SM, Venn SN, Greenwell TJ (2012) The past, present and future of augmentation cystoplasty. BJU Int 109:1280–1293. https://doi.org/10.1111/j.1464-410X.2011.10650.x

    Article  PubMed  Google Scholar 

  2. 2.

    Mundy AR (1999) Metabolic complications of urinary diversion. Lancet 353:1813–1814

    CAS  Article  Google Scholar 

  3. 3.

    Stein R, Rubenwolf P (2014) Metabolic consequences after urinary diversion. Front Pediatr 2:15. https://doi.org/10.3389/fped.2014.00015

    Article  PubMed  PubMed Central  Google Scholar 

  4. 4.

    Hansen EL, Hvistendahl GM, Rawashdeh YFH, Olsen LH (2013) Promising long-term outcome of bladder autoaugmentation in children with neurogenic bladder dysfunction. J Urol. https://doi.org/10.1016/j.juro.2013.05.035

    Article  PubMed  Google Scholar 

  5. 5.

    González R, Ludwikowski BM (2013) Alternatives to conventional enterocystoplasty in children: a critical review of urodynamic outcomes. Front Pediatr. https://doi.org/10.3389/fped.2013.00025

    Article  PubMed  PubMed Central  Google Scholar 

  6. 6.

    Kumar SPV, Abrams PH (2005) Detrusor myectomy: long-term results with a minimum follow-up of 2 years. BJU Int 96:341–344

    Article  Google Scholar 

  7. 7.

    Poppas DP, Uzzo RG, Britanisky RG et al (1996) Laparoscopic laser assisted auto-augmentation of the pediatric neurogenic bladder: early experience with urodynamic followup. J Urol. https://doi.org/10.1016/S0022-5347(01)66390-0

    Article  PubMed  Google Scholar 

  8. 8.

    Cartwright PC, Snow BW (1989) Bladder autoaugmentation: early clinical experience. J Urol 142:505–508 (discussion 520–1)

    CAS  Article  Google Scholar 

  9. 9.

    Marte A, Di Meglio D, Cotrufo AM et al (2002) A long-term follow-up of autoaugmentation in myelodysplastic children. BJU Int. https://doi.org/10.1046/j.1464-410X.2002.02781.x

    Article  PubMed  Google Scholar 

  10. 10.

    MacNeily AE, Afshar K, Coleman GU, Johnson HW (2003) Autoaugmentation by detrusor myotomy: its lack of effectiveness in the management of congenital neuropathic bladder. J Urol 170:1643–1646. https://doi.org/10.1097/01.ju.0000083800.25112.22(discussion 1646)

    Article  PubMed  Google Scholar 

  11. 11.

    Gurocak S, De Gier RPE, Feitz W (2007) Bladder augmentation without integration of intact bowel segments: critical review and future perspectives. J Urol 177:839–844

    Article  Google Scholar 

  12. 12.

    Rocha FT, Bruschini H, Figueiredo JA et al (2011) Use of an inflatable silicone balloon improves the success rate of bladder autoaugmentation at long-term followup. J Urol 185:2576–2581

    Article  Google Scholar 

  13. 13.

    Djordjevic ML, Vukadinovic V, Stojanovic B et al (2015) Objective long-term evaluation after bladder autoaugmentation with rectus muscle backing. J Urol. https://doi.org/10.1016/j.juro.2014.11.081

    Article  PubMed  Google Scholar 

  14. 14.

    Gamé X, Mouracade P, Chartier-Kastler E et al (2009) Botulinum toxin-A (Botox®) intradetrusor injections in children with neurogenic detrusor overactivity/neurogenic overactive bladder: a systematic literature review. J Pediatr Urol 5:156–164

    Article  Google Scholar 

  15. 15.

    Altaweel W, Jednack R, Bilodeau C, Corcos J (2006) Repeated intradetrusor botulinum toxin type A in children with neurogenic bladder due to myelomeningocele. J Urol 175:1102–1105. https://doi.org/10.1016/S0022-5347(05)00400-3

    CAS  Article  PubMed  Google Scholar 

  16. 16.

    Verpoorten C, Buyse GM (2008) The neurogenic bladder: medical treatment. Pediatr Nephrol 23:717–725. https://doi.org/10.1007/s00467-007-0691-z

    Article  PubMed  PubMed Central  Google Scholar 

  17. 17.

    Lendvay TS, Cowan CA, Mitchell MM et al (2006) Augmentation cystoplasty rates at children’s hospitals in the United States: a pediatric health information system database study. J Urol 176:1716–1720. https://doi.org/10.1016/S0022-5347(06)00615-X

    Article  PubMed  Google Scholar 

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I (RS) am the sole author for this manuscript and responsible for all aspects of this manuscript including data analysis and writing/editing.

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Correspondence to Ramnath Subramaniam.

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Subramaniam, R. Experience with detrusorotomy in children by open and robotic approach. World J Urol 38, 1869–1874 (2020). https://doi.org/10.1007/s00345-019-02777-9

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  • Detrusorotomy
  • Autoaugmentation
  • Robotic
  • Children