One - staged reconstruction of bladder exstrophy in male patients: long - term follow-up outcomes

Giron, Amilcar Martins; Mello, Marcos Figueiredo; Carvalho, Paulo Afonso; Moscardi, Paulo Renato Marcelo; Lopes, Roberto Iglesias; Srougi, Miguel

doi:10.1590/s1677-5538.ibju.2015.0581

Cited by 12 publications

(5 citation statements)

References 20 publications

(15 reference statements)

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“…It was not mandatory that initial EEC closure was performed in our institution. At our center initial EEC closure is performed by the technique of complete or 'onestage' closure [5]. Which implements that ureteric reimplantation is not performed during the primary reconstruction.…”

Section: Methodsmentioning

confidence: 99%

Long-Term fate of the upper urinary tract and ITS association with continence in exstrophy patients

Sinatti

Spinoit

Raes

et al. 2021

Journal of Pediatric Urology

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Section: Methodsmentioning

confidence: 99%

Long-Term fate of the upper urinary tract and ITS association with continence in exstrophy patients

Sinatti

Spinoit

Raes

et al. 2021

Journal of Pediatric Urology

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“…Rectus sheath and external oblique muscle aponeurosis with the hypogastric skin have been used for lower abdomen defect closure by Giron et al 12 This flipped-over rectus sheath and external oblique aponeurosis taken from the lateral aspect of the defect on either side are narrow and can weaken the splayed lower rectus muscle layer as it is devoid of a posterior aponeurotic layer by anatomy.…”

Section: Discussionmentioning

confidence: 99%

Abdominal Wall Reconstruction in Adults With Exstrophy of the Bladder

Ete

Kingsly

et al. 2022

Ann Plast Surg

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Introduction Abdominal wall reconstruction in an adult patient with exstrophy bladder is challenging. A variety of local and regional flaps are described. We describe our experience with a 3-layer technique with the differential reconstruction of the fascial and cutaneous layer. Patient and Methods Three adult patients with untreated bladder exstrophy were included in the study period from 2017 and 2019. The surgical technique involved 3-layer abdominal reconstruction involving closure with unilateral anterior rectus sheath turnover and a pedicled anterolateral thigh flap for skin cover reinforced with a mesh between the two. Results All three were male patients with an average age of 22.3 years. The average size of the defect was 10 × 9 cm. The mean period of follow-up was 6 months (range, 2–18 months). In all 3 patients, the flaps settled well with no complications. Conclusions Although rare as they may be, the management of untreated bladder exstrophy presenting in adulthood has evolved over the years. The goals of the management have changed from simple defect closure to the dynamic reconstruction of the abdominal wall covering a continent neobladder. Our technique of a 3-layer closure can provide good functional integrity to the abdominal wall even in large defects.

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“…This flap combined with peritoneum can be used for bladder augmentation as well. Some workers have advocated routine use of this flap in single stage CPRE [24].…”

Section: Discussionmentioning

confidence: 99%

Exstrophy Epispadias Complex: Outcome Analysis of Repair Performed at A Single Centre

Arya¹

2021

AUN

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Objective: The exstrophy-epispadias complex (EEC) is a rare developmental defect which affects multiple systems including the genitourinary system. We share our outcome analysis of 34 surgeries performed on 27 EEC cases at our institution. Material and Methods:This is a retrospective analysis of the outcome and follow up of patients operated for EEC. A total of 27 cases including 15 bladder exstrophy (11 Males, 4 Females) and 19 epispadias (14 Males, 5 Females) were treated from September 2014 to November 2019. Total 34 surgeries were performed on 27 patients which included 7 male cases of closed exstrophy who underwent subsequent epidpadias repair. These included two interesting exstrophy cases also. One of them was a female bladder exstrophy reared as male up to 19 years and another a 31 years male with skin covered exstrophy, diphallia and total urinary incontinence since birth. Epispadias group also included two adult males.Result: Thirteen pediatric patients underwent primary bladder and abdominal closure. Bladder reclosure rate was 14.2%. One adult male underwent Mitrofanoff diversion. The other adult-19 year female had bladder closure, followed by bladder augmentation and rectus flap interposition. Male epispadias repair was performed in 14 patients (7 post closed exstrophy and 7 epispadias). Fistula rate after male epispadias repair was 15.3%. Five females underwent repair for epispadias. Bladder neck reconstruction (BNR) was carried out in 6 patients. Continence rates post BNR was 83% (including social continence). Conclusion:This congenital anomaly requires accomplishment of meticulous repair in staged manner. These cases need follow up from birth to adulthood. Presentation at adult age is extremely rare and related to social stigma, illiteracy and poor access to health care system.

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One - staged reconstruction of bladder exstrophy in male patients: long - term follow-up outcomes

Cited by 12 publications

References 20 publications

Long-Term fate of the upper urinary tract and ITS association with continence in exstrophy patients

Long-Term fate of the upper urinary tract and ITS association with continence in exstrophy patients

Abdominal Wall Reconstruction in Adults With Exstrophy of the Bladder

Exstrophy Epispadias Complex: Outcome Analysis of Repair Performed at A Single Centre

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