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Published on: January 7, 2019
Modified Young-Dees-Leadbetter bladder neck reconstruction after exstrophy repair
Todd Purves1, Thomas Novak, Jeremy King
1Division of Pediatric Urology, Department of Urology, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA. purves@musc.edu
The Journal of Urology
|August 21, 2009
Summary
Bladder neck reconstruction is often needed for urinary continence after initial repair of bladder exstrophy. The modified Young-Dees-Leadbetter technique achieved daytime and nighttime dryness in over half of patients studied.
Area of Science:
- Pediatric Urology
- Reconstructive Surgery
Background:
- Bladder exstrophy requires complex surgical management, often involving complete primary repair in the newborn period.
- Achieving urinary continence post-repair can be challenging, necessitating further reconstructive procedures.
Purpose of the Study:
- To evaluate the application and outcomes of modified Young-Dees-Leadbetter bladder neck reconstruction.
- To assess the efficacy of this technique in achieving urinary continence after initial exstrophy repair.
Main Methods:
- Retrospective review of 34 patients who underwent continence procedures after successful exstrophy closure.
- Analysis of patient characteristics, bladder capacity, and surgical outcomes, including dryness rates.
Main Results:
- Over half (56%) of patients undergoing bladder neck repair achieved complete daytime and nighttime dryness.
- 20% achieved daytime dryness only, while 24% remained totally incontinent.
- Adequate bladder capacity was a prerequisite for successful bladder neck reconstruction.
Conclusions:
- Bladder neck reconstruction is a necessary step for achieving continence in a significant number of patients post-exstrophy repair.
- The modified Young-Dees-Leadbetter technique offers a viable option for improving urinary continence, with over half achieving complete dryness.