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Related Experiment Video

Updated: May 9, 2026

Surgical Management of Meatal Stenosis with Meatoplasty
04:53

Surgical Management of Meatal Stenosis with Meatoplasty

Published on: November 30, 2010

Primary bladder exstrophy closure in neonates: challenging the traditions.

I Mushtaq1, M Garriboli2, N Smeulders1

  • 1Department of Pediatric Urology, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom.

The Journal of Urology
|July 23, 2013
PubMed
Summary

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This study shows that primary bladder exstrophy closure without osteotomy is feasible. Managing patients on the surgical ward with epidural analgesia reduces hospital stays and costs.

Area of Science:

  • Pediatric Surgery
  • Urology

Background:

  • Neonatal bladder exstrophy closure traditionally involves postoperative immobilization and pelvic osteotomy.
  • This approach presents challenges in patient management and resource utilization.

Purpose of the Study:

  • To evaluate a novel approach to neonatal bladder exstrophy closure that omits postoperative immobilization and pelvic osteotomy.
  • To compare the outcomes and cost-effectiveness of different postoperative management strategies.

Main Methods:

  • A retrospective review of 74 neonatal bladder exstrophy primary closures between 2007 and 2011.
  • Comparison of patients managed on a surgical ward with epidural analgesia versus those in the intensive care unit with muscle paralysis and ventilation.
  • Analysis of clinical outcomes including time to feed, length of stay, complications, and redo closures, alongside cost-effectiveness.
Keywords:
BECBEXICUbladder exstrophyclassic bladder exstrophyintensive care unitosteotomyurologic surgical procedures

Related Experiment Videos

Last Updated: May 9, 2026

Surgical Management of Meatal Stenosis with Meatoplasty
04:53

Surgical Management of Meatal Stenosis with Meatoplasty

Published on: November 30, 2010

Main Results:

  • Successful primary closure was achieved in 95% of patients (70/74) without osteotomy.
  • Patients managed on the surgical ward (n=48) had significantly shorter lengths of stay (11 vs 18 days, p <0.0001) compared to intensive care unit patients (n=26).
  • Ward management resulted in substantially lower median costs ($16,214 vs $42,732, p <0.0001) with similar complication rates (8.3% vs 11.5%, p = 0.609).

Conclusions:

  • Primary bladder exstrophy closure without pelvic osteotomy and lower limb immobilization is a feasible and effective surgical option.
  • Postoperative care on a surgical ward utilizing epidural analgesia offers a more efficient and cost-effective approach, leading to shorter hospitalizations.