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Updated: Jun 28, 2025

Vessel-sparing Excision and Primary Anastomosis
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Multi-Institutional Bladder Exstrophy Consortium After 8 Years: The Short- and Intermediate-Term Outcomes.

Dana A Weiss1, Travis W Groth2, Suhaib Abdulfattah Abdulfattah1

  • 1Department of Urology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

The Journal of Urology
|April 15, 2024
PubMed
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This summary is machine-generated.

This study on bladder exstrophy (BE) repair shows promising continence outcomes in boys after complete primary repair of exstrophy (CPRE). While short-term complications occurred, intermediate-term results indicate good voiding function for many patients.

Area of Science:

  • Pediatric Urology
  • Surgical Innovation
  • Reconstructive Surgery

Background:

  • Bladder exstrophy (BE) presents significant surgical and long-term management challenges.
  • Optimizing surgical repair is crucial to minimize complications and maximize functional outcomes.

Purpose of the Study:

  • To evaluate short-term complications and intermediate-term continence outcomes following a standardized approach to complete primary repair of exstrophy (CPRE).
  • To assess the efficacy of a multi-institutional collaboration utilizing unified surgical principles, real-time coaching, and data analysis.

Main Methods:

  • A prospective database collected data from 92 children with classic BE undergoing primary CPRE across three institutions (February 2013 - February 2021).
  • Short-term outcomes (within 90 days) and intermediate-term outcomes (minimum 4-year follow-up for patients operated on Feb 2013-Feb 2017) were analyzed.
Keywords:
bladder exstrophycomplete primary repair of exstrophy (CPRE)consortiumpediatricsreconstructive surgical procedures

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  • Outcomes included surgical complications, upper tract status, vesicoureteral reflux, and bladder voiding/continence status.

    • Main Results:

    • 31% of patients experienced short-term complications within 90 days, necessitating further surgeries in 13 cases.
    • No devastating complications like penile injury or bladder dehiscence were observed.
    • Intermediate-term follow-up (median 5.7 years) in 40 patients showed 33 voiding volitionally, with 40% achieving >1 hour dry intervals.

    Conclusions:

    • The standardized CPRE approach shows encouraging intermediate-term continence rates, particularly in boys.
    • While short-term complications exist, they are manageable, and the collaborative approach aids in optimizing outcomes for bladder exstrophy.
    • Further technique modifications may be needed for girls to address urinary retention concerns.