The Management of Bladder Exstrophy: The Manchester Experience

Dickson, Alan P.

doi:10.1016/j.jpedsurg.2013.11.031

Cited by 51 publications

(15 citation statements)

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“…Ureteric re-implantation is done when the ureters are dilated as a result of V-U refl ux [7] . Patients who underwent MSRE mostly achieved urinary continence and acceptable dry interval during the day but not at night, through a program of CIC [14,15] . Complete dryness day and night after CIC was reported in those who had bladder augmentation [16,17] .…”

Section: Discussionmentioning

confidence: 99%

Case Report: Long Term Follow Up of Bladder Exstrophy Repaired in Stages with Complete Urinary Continence

et al. 2016

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Bladder exstrophy is a rare congenital anomaly displaying symptoms such as the urinary bladder turned inside out, an exposed dorsal urethra, foreshortened penis, anteriorly displaced anus and widely separated symphysis pubis. This abnormality is managed by many methods, one of which includes a functional reconstruction. Themajor goals of surgical intervention are: Preservation of the renal function, achieving urinary continence with adequate sexual function and acceptable cosmetic appearance. In this report we present a long term follow up (25 years) of a male patient with classical type bladder exstrophy, managed at our hospital in stages, he is fully continent and voids spontaneously without clean intermittent self-catheterization, with normal renal function, adequate penile erection and has ejaculation.

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Section: Discussionmentioning

confidence: 99%

Case Report: Long Term Follow Up of Bladder Exstrophy Repaired in Stages with Complete Urinary Continence

et al. 2016

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“…CBE has an incidence of 1:30-40,000 live births and has a male to female ratio of 1.5-5:1 63 . In some European countries, centralisation of CBE care has into nominated paediatric centres has led to focussedfocused expertise and better organization of care 64 . Despite this however, However, a demographic study published in 2012 established that across specialist centres in Europe, only 12 out of 116 units receive more than 6 BE or epispadias referrals each per year 65 .…”

Section: Transitional Care In Bladder Exstrophymentioning

confidence: 99%

Lifelong Congenital Urology: The Challenges for Patients and Surgeons

et al. 2019

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We thank the reviewers and the Journal for their support with this manuscript. We recognize the complex nature of this subject and are eager to get our submission right. Your input is greatly valued.Reviewer #2: I think the paper is improved and more logical in its flow in the current version. Thank you.However, it does not contain very much concrete information/advice and as such I believe it should be shortened. I suggested this in the previous review as well but the new version is longer than before.Further, the purpose of the statement still seem a bit unclear. I would suggest that the authors add a well-defined purpose at the end of the introduction so that the paper can be read in that context.An excellent suggestionwe have added this.Finally, for table 1, lower limits for observations should be noted. It is not really useful for the reader to know that some studies didn't report on the problem and this does not work as lower limits. Reviewer Comments 1 st review Comments to Author:Reviewer #1: The authors present a superficial review or consensus of the challenges posed by patients who need transitional urology care. This topic is not new. This paper would have been informative 5 years ago. As written, there are few or no relevant data, the English needs editing, and it does not add to the current literature. The resources used to meet in Copenhagen to finalize this paper could have been put to better use.We thank the reviewer for their comments. We agree that this is a topic that has been in existence since D.I.Williams, Christopher Woodhouse and Phillip Ransley (and others) began to provide lifelong care for these patients. To date it has been relatively easy to stimulate interest in paediatric urologists who have the cohort of older patientsit remains difficult to stimulate interest in adult practitioners where the need is becoming

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“…The Manchester group has reported continence with urethral voiding in 62% following bladder neck reconstruction, with only 26% of patients completely dry overnight. 38 Massanyi et al outlined the importance of bladder capacity at the time of bladder neck reconstruction after failed exstrophy closure and demonstrated that those with a median volume of 100 mL were more likely to achieve continence than those with a median of 65 mL. Those with the lower capacity were more likely to achieve a favourable result if bladder neck reconstruction was performed concurrently with an enterocystoplasty.…”

Section: Bladder Neck and Continence Managementmentioning

confidence: 99%