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Vesical neck reconstruction in patients with epispadias-exstrophy
M L Ritchey1, S A Kramer, P P Kelalis
1Department of Urology, Mayo Clinic, Rochester, Minnesota 55905.
The Journal of Urology
|June 1, 1988
Summary
Vesical neck reconstruction achieved 77% continence in patients with epispadias-exstrophy complex. Bladder capacity is key for urinary continence, with augmentation cystoplasty improving outcomes in select cases.
Area of Science:
- Pediatric Urology
- Reconstructive Surgery
- Congenital Anomalies
Background:
- The epispadias-exstrophy complex presents significant challenges in urinary continence.
- Vesical neck reconstruction is a critical component in managing these complex congenital anomalies.
Purpose of the Study:
- To evaluate the efficacy of vesical neck reconstruction in achieving urinary continence.
- To identify factors influencing continence outcomes in patients with epispadias-exstrophy complex.
Main Methods:
- Retrospective analysis of 62 patients (50 male, 12 female) undergoing vesical neck reconstruction.
- Assessment of urinary continence rates and bladder capacity post-surgery.
- Evaluation of combined augmentation cystoplasty with vesical neck reconstruction in select cases.
Main Results:
- An overall continence rate of 77% was achieved (35/45 with epispadias, 13/17 with exstrophy).
- Adequate bladder capacity was identified as a crucial determinant of continence.
- Augmentation cystoplasty combined with vesical neck reconstruction successfully improved capacity and continence in 11 patients.
Conclusions:
- Vesical neck reconstruction is an effective procedure for improving urinary continence in the epispadias-exstrophy complex.
- Maintaining or achieving adequate bladder capacity is paramount for successful urinary continence.
- Combined augmentation cystoplasty offers a viable solution for patients with limited bladder capacity.