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Related Experiment Videos

Hypertension following primary bladder closure for vesical exstrophy

D A Husmann1, G A McLorie, B M Churchill

  • 1Division of Urology, Hospital for Sick Children, Toronto, Ontario.

Journal of Pediatric Surgery
|February 1, 1993
PubMed
Summary

Hypertension following bladder exstrophy reconstruction may be linked to skin traction. Removing traction alleviated high blood pressure in three patients, suggesting careful traction application is crucial.

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Area of Science:

  • Pediatric Surgery
  • Urology
  • Nephrology

Background:

  • Bladder exstrophy reconstruction, particularly with posterior iliac osteotomies, is associated with potential complications.
  • Hypertension has been a recognized, though not fully understood, complication following these procedures.

Observation:

  • This report describes three pediatric patients who developed significant hypertension post-primary bladder closure with bony immobilization via skin traction.
  • None of the patients exhibited signs of urinary obstruction.

Findings:

  • Hypertension in these patients resolved completely upon removal of the skin traction.
  • The findings suggest that inappropriately applied traction, potentially causing sciatic nerve tension and reflex vasoconstriction, may be the cause of elevated blood pressure.

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Implications:

  • This highlights the critical need for precise application and monitoring of skin traction during bladder exstrophy repair.
  • Postoperative blood pressure monitoring is essential to identify and manage traction-induced hypertension promptly.