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Evaluation of Biomaterials for Bladder Augmentation using Cystometric Analyses in Various Rodent Models
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Spontaneous bladder rupture in non-augmented bladder exstrophy.

Sarah Giutronich1, Aurélien Scalabre2, Thomas Blanc3

  • 1Department of Paediatric Urology, Royal Children's Hospital, Flemington Road, Parkville, VIC, Australia.

Journal of Pediatric Urology
|August 9, 2016
PubMed
Summary
This summary is machine-generated.

Bladder rupture can occur in patients with bladder exstrophy even without augmentation. Poor bladder emptying and high bladder pressure are key risk factors, potentially requiring surgical intervention.

Keywords:
Bladder exstrophy–epispadias complexBladder ruptureLong-term follow-upUrodynamics

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Area of Science:

  • Pediatric Urology
  • Urology
  • Surgical Innovation

Background:

  • Bladder perforation is a rare but serious complication in patients with bladder exstrophy.
  • This complication is not well-described in non-augmented bladders.

Purpose of the Study:

  • To identify risk factors for spontaneous bladder perforation in patients with classic bladder exstrophy-epispadias (E-E) who have not undergone bladder augmentation.

Main Methods:

  • A retrospective, multi-institutional review was conducted.
  • The study included nine patients (seven male, two female) with classic E-E.
  • Data on surgical history, voiding function, lower urinary tract symptoms, and pre-rupture investigations were analyzed.

Main Results:

  • The mean age at rupture was 11 years.
  • Risk factors identified include poor bladder emptying and high bladder pressures, often associated with lower urinary tract symptoms like frequency and straining.
  • Urodynamic findings of low capacity and high leak point pressures were observed in affected patients.

Conclusions:

  • Bladder rupture is a significant risk in non-augmented bladder exstrophy, potentially life-threatening and often necessitating laparotomy.
  • Urodynamics can help identify at-risk patients.
  • Prompt intervention with clean intermittent catheterization (CIC) and/or augmentation is recommended when poor emptying or high pressures are detected.