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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.
African Journal of Paediatric Surgery : AJPS
|July 1, 2022
Summary
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.
