Construction of a natural looking inverted umbilicus for bladder exstrophy

Area of Science:

• Pediatric Surgery
• Reconstructive Surgery
• Urology

Background:

• Creating an inverted umbilicus in patients with bladder exstrophy often results in a flat scar.
• Existing techniques have limitations in achieving aesthetically pleasing, inverted umbilical structures.

Purpose of the Study:

• To describe a surgical technique for creating a well-formed, inverted umbilicus in the exstrophy abdomen.
• To improve the cosmetic outcome of umbilicoplasty in patients with bladder exstrophy.

Main Methods:

• A total of 19 patients (5 days to 7 years old) underwent the described umbilicoplasty technique.
• The technique involves inverting skin at the apex of the wound and using superiorly based flaps to form the umbilical base.
• Skin and fascia are meticulously repositioned and sutured to the anterior rectus sheath and linea alba.

Main Results:

• The technique successfully created an inverted umbilicus in all 19 patients.
• No instances of infection or wound dehiscence were reported.
• Excellent and durable cosmetic results were achieved in all cases.

Conclusions:

• The described technique provides a reliable method for creating an inverted umbilicus in the exstrophy population.
• Umbilicoplasty can be performed concurrently with bladder closure or as a separate procedure later in life.
• This approach offers a superior cosmetic alternative to flat scars post-exstrophy repair.