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Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Outcome of complete primary bladder exstrophy repair: single-center experience
A I Shoukry1, A M Ziada, H A Morsi
1Division of Pediatric Urology, Cairo University Pediatric Hospital, Cairo, Egypt. ahmed@mdlinked.com
Journal of Pediatric Urology
|May 19, 2009
Summary
Complete primary repair for bladder exstrophy is challenging. Many patients require further procedures, including augmentation cystoplasty, to achieve urinary continence.
Area of Science:
- Pediatric Urology
- Reconstructive Surgery
Background:
- Bladder exstrophy reconstruction presents significant surgical challenges.
- Complete primary repair is a common approach for classic bladder exstrophy.
Purpose of the Study:
- To evaluate the outcomes of complete primary repair for classic bladder exstrophy.
- To assess continence, upper urinary tract status, and cosmetic results.
Main Methods:
- Retrospective review of 51 classic bladder exstrophy patients (May 2000-September 2007).
- Mean follow-up of 3 years.
- Evaluation included continence, upper tract dilatation, and cosmetic outcome.
Main Results:
- 15.6% of closures failed, and 11.7% developed fistulae.
- 37% achieved continence with clean intermittent catheterization after age 5.
- Augmentation cystoplasty was necessary for dryness in many patients.
Conclusions:
- Bladder exstrophy reconstruction often requires multiple surgical procedures.
- Augmentation cystoplasty is frequently needed to achieve acceptable urinary continence.
- Initial favorable results in young patients may not predict long-term continence.