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Updated: Sep 6, 2025
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Bladder exstrophy: Modern staged repair experience in our institution
Kouam Soroboua Agbara1, Olivier Martial Moulot1, Manuela Adjoba Ehua1
1Department of Mother-Children, Félix Houpouet Boigny University, Cocody; Department of Mother-Children, Teaching Hospital, Treichville, Abidjan, Ivory Coast.
Insights
Bladder exstrophy management in Sub-Saharan Africa presents challenges. This study reviews surgical repair experiences, highlighting complications and limitations due to financial and technical constraints.
Area of Science:
- Paediatric Urology
- Congenital Malformations
Background:
- Bladder exstrophy is a significant congenital anomaly requiring complex surgical management.
- Current treatment outcomes for bladder exstrophy remain suboptimal, particularly in resource-limited settings like Sub-Saharan Africa.
Purpose of the Study:
- To report the management experience and challenges of classic bladder exstrophy in a Sub-Saharan African context.
- To identify factors influencing treatment outcomes and explore strategies for improvement.
Main Methods:
- Retrospective review of 25 patients with classic bladder exstrophy treated between January 2010 and December 2019.
- Analysis of epidemiological, clinical, therapeutic, and evolution data.
Main Results:
- Twenty-five patients (16 boys, 9 girls) underwent surgical repair, including bladder closure (25), pelvic osteotomy (11), and epispadias repair (9).
- Complications included bladder fistulas (6), wound dehiscence (4), and urinary tract infections (6).
- Urinary continence was achieved in 8 children, with 1-2 hours of continence.
Conclusions:
- Treatment of bladder exstrophy in this region is hampered by financial difficulties and limited technical infrastructure.
- Improving surgical outcomes requires addressing socioeconomic barriers and enhancing healthcare resources.
Introduction:
Bladder exstrophy is a major malformation in paediatric urology. The treatment results are not still completely satisfactory, and their management is an enormous problem in Sub-Saharan Africa. While outlining our challenges, we report our management experience to improve our results.
Subjects And Methods:
We retrospectively reviewed the records of patients undergoing surgical repair of classic bladder exstrophy at our department between January 2010 and December 2019 (10 years). Epidemiological, clinical, therapeutic and evolution data were analysed.
Results:
Twenty-five children with classic bladder exstrophy were treated. Our series included 16 boys and 9 girls with a sex ratio of 1.7. Age ranged from 0 day to 6 years. Twenty-five bladder closures were performed, associated to pelvic osteotomy in 11 cases. Epispadias repair was performed on nine boys. Eight cases of bladder neck reconstruction and three cases of bladder enlargement were performed. We observed six bladder fistulas, four wound dehiscence, of which three partial, two parietal suppurations and six cases of urinary tract infection. Eight children had a continence of 1-2 h.
Conclusion:
The treatment of bladder exstrophy in our context is still limited because of financial difficulties encountered by the population and the insufficient technical platform in our country.
