Outcome of complete primary bladder exstrophy repair: Single-center experience |
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| Authors: | AI Shoukry AM Ziada HA Morsi EI Habib A Aref HA Badawy M Eissa M Daw |
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| Institution: | 1. Division of Pediatric Urology, Cairo University Pediatric Hospital, Cairo, Egypt;2. Urology Department, Bani Sweif University, Egypt;1. Rady Children''s Hospital, San Diego, CA;2. University of California, San Diego, CA;3. Vanderbilt University, Nashville, TN;4. University Medical Center, Hamburg, Germany;5. University of Alexandria, Egypt;6. Children''s Hospital of Philadelphia, Philadelphia, PA;7. University of Pennsylvania, Philadelphia, PA;1. Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, JHOC 8, 601 North Caroline Street, Baltimore, MD 21287, USA;2. Department of Radiology, State University of New York Downstate Medical Center, 450 Clarkson Avenue #24, Brooklyn, NY 11203, USA;3. Department of Urology, Johns Hopkins University School of Medicine, 1800 Orleans Street #7304, Baltimore, MD 21287, USA;1. Pediatric Surgery Department, King Abdul Aziz Specialist Hospital, Taif, Saudi Arabia;2. Al-Azhar University, Cairo, Egypt;1. Division of Pediatric Urology, Seattle Children''s Hospital, Seattle, WA, USA;2. Department of Urology, University of Washington, Seattle, WA, USA |
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| Abstract: | ObjectiveReconstruction of bladder exstrophy remains a challenge. We evaluated our experience with complete primary repair in classic bladder exstrophy.MethodsA retrospective data review was conducted of bladder exstrophy patients presenting at our institution between May 2000 and September 2007. Fifty-one patients (21 females and 30 males) with classic bladder exstrophy were included. Age of presentation ranged from 24 h to 14 months. Mean follow up was 3 years (1 month–7 years). Patients were evaluated for continence, upper tract dilatation and cosmetic result.ResultsEight patients (15.6%) had failed closures and six (11.7%) had fistulae. Evaluation of continence excluded 16 patients not followed up at our center. Thirty-seven percent were continent on clean intermittent catheterization after the age of 5 years. Patients became dry only after augmentation cystoplasty. Upper tract changes were mild during our study with all patients having normal serum creatinine.ConclusionPatients may require more than one procedure for reconstruction. In our series, augmentation was required to achieve acceptable dryness. Early promising results with dry intervals in young patients did not translate to continence in older patients. |
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