Anatomy of Classic Bladder Exstrophy: MRI Findings and Surgical Correlation

Dunn, Emily; Kasprenski, Matthew; Facciola, James; Benz, Karl; Maruf, Mahir; Zaman, Mohammad H.; Gearhart, John P.; Carlo, Heather Di; Tekes, Aylin

doi:10.1007/s11934-019-0916-2

Cited by 10 publications

(3 citation statements)

References 36 publications

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“…Other approaches include the Mainz II repair, the radical soft tissue mobilization, the Erlangen approach, and the Warsaw approach. 2 As a major deformity, CBE not only has a profound impact on physical function in adulthood but also gives rise to a range of psychological, social, and professional disabilities among affected individuals. 3 Berrettini et al 4 conducted a rigorous investigation, systematically examining the sexual function and psychosexual correlates among individuals with the exstrophy-epispadias complex.…”

Section: Discussionmentioning

confidence: 99%

“…The modern staged repair of exstrophy and the complete primary repair of exstrophy are 2 widely used surgical methods. Other approaches include the Mainz II repair, the radical soft tissue mobilization, the Erlangen approach, and the Warsaw approach 2 . As a major deformity, CBE not only has a profound impact on physical function in adulthood but also gives rise to a range of psychological, social, and professional disabilities among affected individuals 3 .…”

Section: Discussionmentioning

confidence: 99%

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An Analysis of the Efficacy of Multilayered Repair and Reconstruction Using Combined Tissue Pedicle Flaps for Abdominal Wall Defects in Adult Bladder Exstrophy Patients

Azhati,

Dilixiati,

Reheman

et al. 2024

Ann Plast Surg

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Objective In this study, we conducted a retrospective analysis of cases involving adult classic bladder exstrophy (CBE) accompanied by the absence of the abdominal wall. Specifically, we focused on the utilization of multilayer flaps for reconstructive purposes. In addition, we aimed to share our clinical treatment experience pertaining to similar challenges, thereby providing valuable insights to complement the surgical management of this rare disease. Methods We conducted a retrospective analysis of 12 adult patients diagnosed with CBE who underwent initial treatment between June 2013 and January 2020. All patients underwent multilayer reconstruction to address their abdominal wall defects. This involved utilizing shallow flaps derived from the superficial fascia of the abdomen and incorporating myofascial flaps composed of the anterior sheath of the rectus abdominis and aponeurosis of the external oblique muscle. The flap sizes ranged from 9 × 11 cm to 13 × 15 cm. Results Abdominal wall reconstruction in the 12 patients with CBE resulted in an absence of wound dehiscence recurrence, urinary obstruction, or urinary tract infection. All patients expressed satisfaction with the aesthetic outcome of their abdominal wall based on self-evaluation. They reported a successful resumption of normal life and work activities without experiencing any restrictions. The married patients expressed contentment with their sexual function. Conclusion The utilization of a multilayered reconstruction technique involving multiple flaps in adults with congenital CBE allows for successful restoration of urinary function, as well as the attainment of sufficient abdominal wall strength to support daily life and work activities, while preserving sexual function. However, it is important to approach the evaluation of surgical outcomes with caution because of the rarity of this condition and the lack of objective assessment measures.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

An Analysis of the Efficacy of Multilayered Repair and Reconstruction Using Combined Tissue Pedicle Flaps for Abdominal Wall Defects in Adult Bladder Exstrophy Patients

Azhati,

Dilixiati,

Reheman

et al. 2024

Ann Plast Surg

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“…It is worth noting that 100.0% accuracy was proven in all patients in the correlation of gross anatomical landmarks with the 3D iMRI-identified landmarks, and all patients had a successful reconstruction with no major perioperative complications. Ongoing studies of imaging guidance in BEEC repair were warranted, as the surgical techniques are improving over the years [ 55 ].…”

Section: Intraoperative Magnetic Resonance Imaging (Imri)mentioning

confidence: 99%

Fluorescence-Guided Surgery and Novel Innovative Technologies for Improved Visualization in Pediatric Urology

Paraboschi

Mantica

Minoli

et al. 2022

IJERPH

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Fluorescence-guided surgery (FGS), three-dimensional (3D) imaging technologies, and other innovative devices are rapidly revolutionizing the field of urology, providing surgeons with powerful tools for a more complete understanding of patient-specific anatomy. Today, several new intraoperative imaging technologies and cutting-edge devices are available in adult urology to assist surgeons in delivering personalized interventions. Their applications are also gradually growing in general pediatric surgery, where the detailed visualization of normal and pathological structures has the potential to significantly minimize perioperative complications and improve surgical outcomes. In the field of pediatric urology, FGS, 3D reconstructions and printing technologies, augmented reality (AR) devices, contrast-enhanced ultrasound (CEUS), and intraoperative magnetic resonance imaging (iMRI) have been increasingly adopted for a more realistic understanding of the normal and abnormal anatomy, providing a valuable insight to deliver customized treatments in real time. This narrative review aims to illustrate the main applications of these new technologies and imaging devices in the clinical setting of pediatric urology by selecting, with a strict methodology, the most promising articles published in the international scientific literature on this topic. The purpose is to favor early adoption and stimulate more research on this topic for the benefit of children.

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Bladder Exstrophy

Gearhart²

2023

Pediatric Surgery

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Anatomy of Classic Bladder Exstrophy: MRI Findings and Surgical Correlation

Cited by 10 publications

References 36 publications

An Analysis of the Efficacy of Multilayered Repair and Reconstruction Using Combined Tissue Pedicle Flaps for Abdominal Wall Defects in Adult Bladder Exstrophy Patients

An Analysis of the Efficacy of Multilayered Repair and Reconstruction Using Combined Tissue Pedicle Flaps for Abdominal Wall Defects in Adult Bladder Exstrophy Patients

Fluorescence-Guided Surgery and Novel Innovative Technologies for Improved Visualization in Pediatric Urology

Bladder Exstrophy

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