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Penile deformity in bladder exstrophy: correlation with closure of pelvic defect
G A McLorie1, M C Bellemore, R B Salter
1Division of Urology, Hospital for Sick Children, University of Toronto, Ontario, Canada.
Journal of Pediatric Surgery
|February 1, 1991
Summary
Penile deformity in exstrophy-epispadias complex can cause long-term disability. Closing pubic diastasis via iliac osteotomies may increase penile length, supporting clinical findings.
Area of Science:
- Urology
- Pediatric Surgery
- Anatomy
Background:
- Penile deformity is a significant cause of long-term disability in males with the exstrophy-epispadias complex.
- Understanding the relationship between pelvic bone separation and penile length is crucial for surgical planning.
Purpose of the Study:
- To investigate the impact of pelvic bony element separation on penile length and configuration.
- To determine if closure of pubic diastasis influences effective penile length.
Main Methods:
- An in vitro model using an adult male pelvis and an inflatable penile prosthesis was created.
- The relationship between interpubic distance and penile length was analyzed.
- The effect of closing the "open book" pelvic deformity on penile length was simulated.
Main Results:
- Closure of the "open book" pelvic deformity in the model led to an increase in penile length.
- The study suggests that iliac osteotomies are an effective method for closing pubic diastasis.
- This anatomical finding supports the clinical observation that pelvic osteotomies can enhance penile length.
Conclusions:
- Pelvic bone separation in the exstrophy-epispadias complex negatively impacts penile length.
- Surgical closure of pubic diastasis, particularly through iliac osteotomies, can improve penile length.
- This approach, combined with bladder exstrophy closure, may enhance functional outcomes for affected males.