Vesical exstrophy with epispadias. Twenty-year follow-up

Area of Science:

• Urology
• Pediatric Surgery
• Reconstructive Surgery

Background:

• Bladder exstrophy and epispadias are complex congenital anomalies requiring surgical correction.
• Achieving long-term urinary continence and preventing vesicoureteral reflux are primary goals in surgical repair.
• Previous reports often describe challenges in maintaining successful outcomes over extended periods.

Observation:

• This case presents a patient with a history of bladder exstrophy and epispadias undergoing surgical repair.
• The patient achieved successful anatomic closure with sustained urinary continence and absence of reflux for an extended duration.
• Persistent squamous metaplasia in the bladder was noted despite successful closure and management.

Findings:

• The reported case represents one of the longest successful outcomes for anatomic closure of bladder exstrophy and epispadias.
• The surgical method employed did not reveal a specific "secret" but led to durable functional results.
• The persistence of squamous metaplasia underscores the complex tissue changes that can occur in the bladder.

Implications:

• This case provides valuable long-term data for reconstructive urology and pediatric surgical management of bladder exstrophy.
• The findings suggest that successful outcomes are achievable even in complex cases with meticulous surgical technique.
• Further research into the management of associated bladder pathologies like squamous metaplasia is warranted.