Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Continent urinary diversions in the exstrophy complex: why do they fail?

Dominic Frimberger1, Yegappan Lakshmanan, John P Gearhart

  • 1Brady Urological Institute, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

The Journal of Urology
|September 23, 2003
PubMed
Summary

Urinary continence in exstrophy patients can fail due to issues like nipple valve de-intussusception or bladder neck incompetence. Most patients achieve continence after multiple revisions, highlighting the need for persistent surgical management.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

The effect of neonatal partial upper and lower urinary tract obstruction on the intestinal microbiome in a murine animal model.

Journal of pediatric urology·2026
Same author

Repeat pelvic osteotomy improves the management of failed bladder closure in cloacal exstrophy.

Journal of pediatric surgery·2026
Same author

Evaluating pain management strategies following hypospadias repair: a survey of pediatric urologists.

The Canadian journal of urology·2026
Same author

Pubic diastasis as a predictor of continence outcomes in the isolated male epispadias patient: An innovative prognostic factor.

Journal of pediatric urology·2026
Same author

Multidisciplinary perioperative management of cloacal exstrophy bladder closure: A single institution's approach.

Journal of pediatric urology·2026
Same author

Invited commentary on: Psychological and sexual outcomes in patients with bladder exstrophy and their caregivers.

Journal of pediatric surgery·2025

Area of Science:

  • Pediatric Urology
  • Surgical Reconstruction
  • Bladder Exstrophy Management

Background:

  • Urinary continence is a key goal in exstrophy treatment.
  • Failed bladder neck reconstruction or inadequate bladder capacity necessitates continent urinary reservoirs.
  • Persistent incontinence significantly impacts quality of life.

Purpose of the Study:

  • To evaluate reasons for urinary diversion failure in exstrophy patients.
  • To assess management strategies for achieving urinary continence after initial failure.

Main Methods:

  • Retrospective review of 748 exstrophy complex patients.
  • Identified 92 patients with failed continent urinary diversion and incontinence.
  • Analyzed initial diagnosis, prior surgeries, failure reasons, and management outcomes.

Related Experiment Videos

Main Results:

  • 19 out of 92 patients (21%) experienced initial diversion failure.
  • Common failure reasons included nipple valve de-intussusception and bladder neck incompetence.
  • 97% of patients achieved continence after a mean of 5 revisions, with 89% successful.

Conclusions:

  • Failed continent urinary diversion in exstrophy patients often involves complex surgical histories.
  • De-intussusception was a primary cause of nipple valve stoma failure.
  • Successful management requires thorough preoperative assessment and persistent surgical intervention.