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[Current treatment of bladder exstrophy].

J Bruézière1, G Audry, P Méria

  • 1Service de Chirurgie Viscérale Pédiatrique, Hôpital Armand Trousseau, Paris.

Annales D'Urologie
|January 1, 1992
PubMed
Summary
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Advances in bladder exstrophy treatment significantly improve outcomes. Surgical techniques now offer better urinary continence and genital reconstruction, though male sterility remains a challenge.

Area of Science:

  • Pediatric Surgery
  • Urology
  • Congenital Abnormalities

Context:

  • Vesical exstrophy is a complex congenital anomaly requiring multi-stage surgical intervention.
  • Significant advancements in surgical techniques have occurred over the past two decades.
  • Optimal timing and integrated approaches are crucial for successful management.

Purpose:

  • To review the recent advancements in the surgical treatment of vesical exstrophy.
  • To highlight key surgical progresses and their impact on patient outcomes.
  • To discuss the management of associated urinary and genital anomalies.

Summary:

  • Modern vesical exstrophy treatment involves early bladder closure (within 72 hours), iliac osteotomy, penile lengthening, and entero-cystoplasty when needed.

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  • Coordinated surgical timing allows simultaneous correction of urinary and genital defects.
  • Approximately 80% of patients achieve good urinary continence with current methods; urinary diversion may be necessary for persistent incontinence.

    • Impact:

    • Reconstructive surgery restores near-normal genital anatomy in both sexes, facilitating satisfactory sexual function.
    • While functional outcomes have improved, a high rate of male sterility persists.
    • These surgical improvements offer enhanced quality of life for individuals with vesical exstrophy.