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Evaluation of Biomaterials for Bladder Augmentation using Cystometric Analyses in Various Rodent Models
Published on: August 9, 2012
The use of bladder neck reconstruction in bladder exstrophy.
1Department of Surgery (Urology), Harvard Medical School and Assistant in Urology, Children's Hospital Boston, Boston, MA 02115, USA. joseph.borer@childrens.harvard.edu
Seminars in Pediatric Surgery
|April 2, 2011
Summary
Most bladder exstrophy patients require bladder neck reconstruction (BNR) after complete primary repair of exstrophy (CPRE). This surgery is more frequently needed in males and significantly increases bladder capacity post-operatively.
Area of Science:
- Pediatric Urology
- Surgical Reconstruction
- Continence Management
Background:
- Achieving urinary continence is a primary goal in bladder exstrophy (BE) management.
- Bladder neck reconstruction (BNR) is a common surgical approach following complete primary repair of exstrophy (CPRE).
Purpose of the Study:
- To report the outcomes of bladder neck reconstruction (BNR) in patients with bladder exstrophy (BE) after complete primary repair of exstrophy (CPRE).
- To evaluate the impact of BNR on bladder capacity and continence.
- To identify factors influencing the need for BNR.
Main Methods:
- Prospective evaluation of 47 BE patients (1994-2010) after CPRE.
- Data collection included patient history, ultrasound, voiding cystourethrogram (VCUG), and urodynamic study (UDS).
- Continence defined as a dry interval >3 hours; incontinence as <1-hour interval. Bladder capacity and compliance assessed via VCUG/UDS.
Main Results:
- BNR was performed in 41% of males and 27% of females at a mean age of 6.3 and 5.9 years, respectively.
- Mean bladder capacity significantly increased post-BNR (P = 0.013) and showed sustained improvement (P = 0.002).
- The need for BNR was more prevalent in male patients.
Conclusions:
- Most patients with bladder exstrophy require bladder neck reconstruction after complete primary repair.
- Bladder neck reconstruction is associated with improved bladder capacity.
- Male patients demonstrate a higher incidence of requiring bladder neck reconstruction.
