Related Experiment Video

Updated: May 23, 2026

Vessel-sparing Excision and Primary Anastomosis
08:09

Vessel-sparing Excision and Primary Anastomosis

Published on: January 7, 2019

Urinary diversion in early childhood: indications and outcomes in the exstrophy patients

Nima Baradaran1, Andrew Stec, Ming-Hsien Wang

  • 1Division of Pediatric Urology, Brady Urological Institute Johns Hopkins Medical Institutions, Baltimore, MD, USA.

Urology
|April 21, 2012
PubMed

Insights

Urinary diversion in early childhood for classic bladder exstrophy (CBE) is safe and effective. Both continent and incontinent urinary diversion (CUD and IUD) can lead to favorable continence outcomes, with CUD showing better initial success rates.

Area of Science:

  • Pediatric Urology
  • Surgical Reconstruction
  • Bladder Exstrophy Management

Background:

  • Classic bladder exstrophy (CBE) often requires complex surgical management.
  • Early childhood urinary diversion is sometimes necessary for patients with CBE.
  • Continent and incontinent urinary diversion (CUD and IUD) are surgical options.

Purpose of the Study:

  • To evaluate the indications for and applicability of CUD and IUD.
  • To assess outcomes in early childhood patients with CBE undergoing urinary diversion.
  • To determine the safety and efficacy of these procedures in young children.

Main Methods:

  • Retrospective review of a CBE database for patients undergoing CUD or IUD within the first five years of life.
  • Analysis of surgical indications, procedures performed, and clinical outcomes.
  • Study included patients born after 1980 treated by two surgeons.

Main Results:

  • In the CUD group (n=14), 21% had successful primary closure; indications included desire for dryness and upper tract changes. All patients achieved dryness with clean intermittent catheterization (CIC).
  • In the IUD group (n=5), only one had successful primary closure; indications included severe hydronephrosis and recurrent UTIs. Four were later re-diverted to CUD. All achieved social dryness via catheterization.
  • No cases of renal function loss or malignant transformation were observed in either group.

Conclusions:

  • Early urinary diversion in CBE is often necessitated by upper tract deterioration and social factors.
  • Both CUD and IUD can achieve favorable continence outcomes in young children with CBE.
  • Urinary diversion is a safe and effective option for managing complex bladder exstrophy cases in early childhood.
Abstract

More Related Videos

Surgical Model for Single-Staged Tissue-Engineered Urothelial Tubes in Minipigs04:05

Surgical Model for Single-Staged Tissue-Engineered Urothelial Tubes in Minipigs

Published on: July 5, 2024

Related Concept Videos

Imaging Studies VI: Voiding Cystourethrography and Cystography01:22

Imaging Studies VI: Voiding Cystourethrography and Cystography

Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...
Urinary Tract Calculi VI: Surgical Management01:25

Urinary Tract Calculi VI: Surgical Management

Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
Urologic Endoscopic Procedure: Cystoscopic Examination01:28

Urologic Endoscopic Procedure: Cystoscopic Examination

Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...
Imaging Studies V: Intravenous Urography and Retrograde Pyelography01:22

Imaging Studies V: Intravenous Urography and Retrograde Pyelography

IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...