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Management of ectopia vesica in Ibadan: an 8-year review
1Department of Surgery, College of Medicine, University of Ibadan. obshittu@skannet.com
Insights
Immediate bladder closure for ectopia vesica in children can be successful. Darning sutures for muscle and fascial closure reduced wound complications compared to simple nylon approximation.
Area of Science:
- Pediatric Surgery
- Urology
- Congenital Anomalies
Background:
- Ectopia vesica management is complex, with social stigma posing significant risks.
- Early bladder repair is crucial to prevent abandonment or infanticide.
Purpose of the Study:
- To document the experience with ectopia vesica management at University College Hospital (UCH), Ibadan.
- To evaluate surgical outcomes over an 8-year period.
Main Methods:
- Primary bladder closure for all pediatric ectopia vesica cases.
- Comparison of symphysial approximation (1995-1998) versus darning suture closure (post-1998).
Main Results:
- 13 children with ectopia vesica were treated.
- Darning suture closure of muscle and fascial layers showed reduced abdominal wound dehiscence.
- Simple nylon symphysial approximation was associated with higher dehiscence rates.
Conclusions:
- Immediate bladder closure for pediatric ectopia vesica can yield satisfactory results.
- Continued experience is vital for optimizing management and outcomes.
Context:
The management of children with ectopia vesica is intricate and complex. Repair of the bladder soon after delivery is desirable, particularly in our environment as the social stigma associated with such an anomaly can lead to child abandonment or infanticide.
Objective:
To report our experience in the management of children with ectopia vesica at the University College Hospital (UCH), Ibadan, over an 8-year period.
Study Design, Setting And Subjects:
All children who presented at the UCH, Ibadan between January 1995 and December 2002 with ectopia vesica had the bladder closed primarily. The children that presented between 1995 and 1998 had the symphysial diastasis approximated with no. 1 nylon suture, while those that presented subsequently had the muscle and fascial layer closed with a darning suture of no. 1 nylon.
Result:
A total of 13 children presented with ectopia vesica during the period of the study. The bladder was closed in all cases. Abdominal wound dehiscence occurred less frequently in patients who had darning suture approximation of the muscle and fascial layer, compared with those who had simple symphysial approximation with nylon suture.
Conclusion:
The result of immediate bladder closure in children with ectopia vesica can be satisfactory in this environment. There is a need for continuing experience in the management of these children to improve outcome.
