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Results of surgical treatment in children with bladder exstrophy
1Department of Urology, Heim Pál Children's Hospital, Budapest, Hungary.
Insights
This study on bladder exstrophy surgery in children found that while ureterosigmoidostomy had drawbacks, most patients adapted well. Over half were symptom-free, demonstrating successful long-term outcomes for bladder exstrophy repair.
Area of Science:
- Pediatric Surgery
- Urology
- Reconstructive Surgery
Background:
- Bladder exstrophy is a complex congenital anomaly requiring surgical intervention.
- Long-term outcomes and complications of various surgical techniques for bladder exstrophy are critical to understand.
Purpose of the Study:
- To evaluate the surgical outcomes and long-term follow-up of children treated for bladder exstrophy.
- To assess the efficacy and complications of primary bladder closure and ureterosigmoidostomy.
Main Methods:
- Retrospective analysis of 42 children undergoing bladder exstrophy surgery between 1972 and 1989.
- Surgical procedures included primary bladder closure and ureterosigmoidostomy.
- Follow-up ranged from 2 to 20 years.
Main Results:
- Primary bladder closure was successful in 6 of 11 patients.
- Ureterosigmoidostomy was performed in 35 patients, with 50% symptom-free at long-term follow-up.
- Common complications included acidosis and urinary tract dilatation; others like hypokalaemia and pyelonephritis were infrequent.
Conclusions:
- Ureterosigmoidostomy, despite disadvantages, allowed patients to adapt and lead normal lives.
- Surgical management of bladder exstrophy can yield positive long-term functional outcomes.
- Continued monitoring is essential for managing potential complications such as acidosis and urinary tract dilatation.
Abstract:
A series of 42 children (30 boys and 12 girls) underwent surgery for bladder exstrophy between 1972 and 1989. Primary bladder closure was performed in 11 patients and was successful in 6. Four of these children are about 2 years old and so it is not yet possible to assess their continence. Ureterosigmoidostomy was performed in 35 children, one of whom was converted to cutaneous ureterostomy. Follow-up ranges from 2 to 20 years (average 9 years 3 months) and 50% of the patients are symptom-free. The most frequent problems were acidosis and urinary tract dilatation. Other complications, such as hypokalaemia and pyelonephritis, were seldom seen. Although ureterosigmoidostomy has some disadvantages, our patients have adapted well and lead a normal life.