Horizontal pelvic osteotomies for bladder exstrophy. A preliminary report

Area of Science:

• Pediatric Surgery
• Urology
• Orthopedic Surgery

Background:

• Bladder exstrophy is a complex congenital anomaly requiring surgical correction.
• Traditional surgical methods for bladder exstrophy can be challenging, especially in severe or recurrent cases.
• Horizontal osteotomies of the innominate bones were previously used for older patients with significant deformities.

Purpose of the Study:

• To evaluate the efficacy and safety of horizontal osteotomies of the innominate bones as a primary procedure for bladder exstrophy in neonates.
• To assess the feasibility of correcting complex bladder exstrophy malformations in a single-stage operation using this technique.
• To report early outcomes and complications associated with this early-life surgical intervention.

Main Methods:

• Treatment of 11 patients aged three days to 15 years with bladder exstrophy.
• Application of horizontal osteotomies of the innominate bones as a primary surgical procedure within the first week of life.
• Simultaneous correction of pubic bone diastasis, abdominal wall defects, bladder closure, and reconstruction of the urethra and external genitalia.

Main Results:

• Satisfactory early results were achieved in all 11 treated patients.
• The procedure allowed for the correction of complex malformations in a single operation without patient repositioning.
• Only minor complications were observed during the follow-up period.

Conclusions:

• Horizontal osteotomies of the innominate bones represent a safe and effective primary surgical treatment for bladder exstrophy in neonates.
• This technique facilitates single-stage correction of complex bladder exstrophy, simplifying the management of this congenital anomaly.
• Early satisfactory outcomes suggest this approach holds significant promise for improving the treatment of bladder exstrophy.