Bilateral Rectus Femoris Pedicle Flaps for Detrusor Augmentation in the Prune Belly Syndrome

A 20-year-old patient with the prune belly syndrome presented with urinary retention and renal failure. In preparation for renal transplantation bladder rehabilitation, consisting of urethral dilation, reduction cystoplasty and detrusor augmentation with paired rectus femoris pedicle flaps, was undertaken. This procedure enabled the patient to empty the bladder totally by spontaneous voiding. Successful renal transplantation was performed subsequently and he has not required intermittent or continuous catheterization. The surgical approach and technique are described, and their application to other conditions of detrusor hypotonicity is discussed.