Anterior Innominate Osteotomy in Repair of Bladder Exstrophy

Sponseller, Paul D.; Jani, Mihir M.; Jeffs, Robert D.; Gearhart, John P.

doi:10.2106/00004623-200102000-00005

Cited by 132 publications

(75 citation statements)

References 10 publications

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“…It also greatly facilitates performing the urological procedure. This technique requires a shorter time to perform: it can be used for older patients and corrects the deformities better (7,9,(11)(12)(13)(14)(15) . Stec et al (12,13) reported that there was an increase in external rotation of the sacroiliac joints of the- se patients (Figure 10).…”

Section: Discussionmentioning

confidence: 99%

“…These abnormalities consequently make the progression angle of the foot around 20 to 30º of external rotation greater than normal, but with improvement with increasing age, and the gait has a widened base, associated with dysplasia of hip development (7,8) . In patients who do not undergo osteotomy together with closure of the bladder, there is higher incidence of premature hip arthrosis (9) .…”

Section: Remarks About Exstrophymentioning

confidence: 99%

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Osteotomia pélvica anterior bilateral para o fechamento de extrofia de bexiga: descrição de técnica

et al. 2011

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Section: Discussionmentioning

confidence: 99%

Section: Remarks About Exstrophymentioning

confidence: 99%

Osteotomia pélvica anterior bilateral para o fechamento de extrofia de bexiga: descrição de técnica

et al. 2011

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“…Foi observado, também, que os pacientes com diastase inferior a dois centímetros tiveram melhores resultados quanto à continência urinaria (13) . Observou-se índice similar de excelentes resultados (55%), levando-se em conta, exclusivamente, pacientes que não apresentaram qualquer tipo de complicação pós-operatória.…”

Section: Discussionunclassified

“…Sponseller et al (14) relataram os benefícios da osteotomia na falha da reconstrução sem esse procedimento. Esses autores utilizaram uma osteotomia transversa dos ilíacos semelhante à de Salter, com bons resultados (13,14) . Em nenhum caso foi utilizada técnica parecida.…”

Section: Discussionunclassified

Tratamento da extrofia de bexiga: osteotomia posterior dos ossos ilíacos e fechamento da pelve com cinta de náilon

Nogueira¹,

Ramos²,

Machado³

et al. 2011

Rev. bras. ortop.

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RESUMOObjetivo: Avaliou-se o resultado obtido em nove correções cirúrgicas de extrofia de bexiga em pacientes pediátricos. Métodos: Foi utilizada osteotomia posterior dos ossos ilíacos seguida pelo fechamento da pelve com cinta de náilon. INTRODUÇÃOA extrofia de bexiga é uma anomalia congênita rara decorrente de falha da fusão dos tecidos da linha média da pelve durante a embriogênese e caracteriza-se por má formação da região inferior da parede abdominal envolvendo o trato geniturinário e o sistema musculoesquelético (1,2) . Apresenta incidência estimada em 1:30.000 a 1:50.000 nascidos vivos, sendo duas a três vezes mais frequente no sexo masculino (3)(4)(5) . Na extrofia vesical clássica a parede anterior da parte posterior da bexiga está exposta e alterações como epispádia, displasia dos músculos do assoalho pélvico, pênis curto ou clitóris bifurcado acompanham o quadro clinico (1,4) . O dismorfismo da pelve representado pela diástase da sínfise púbica, expansão lateral dos ossos inominados e rotação lateral dos acetábulos está invariavelmente presente nessa afecção (6) .

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“…Pubic separation will occur with later growth [10]; the extent of pubic separation depends on the age at which osteotomy is undertaken and when performed in adolescence, pubic separation remains minimal.…”

Section: Discussionmentioning

confidence: 99%

Bladder neck reconstruction in classic bladder exstrophy: the role of osteotomy in the development of continence

Mathews¹,

Sponseller

Jeffs³

et al. 2000

BJU International

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Objective To assess the role of osteotomy at the time of bladder neck reconstruction (BNR) for continence in classic bladder exstrophy, in which closure of the pelvic ring and reconstitution of the pelvic diaphragm may affect eventual continence. Patients and methods The results of using osteotomy at the time of BNR in 29 children were reviewed. The mean bladder capacity before BNR was 76 mL. The indications for osteotomy were a wide pubic diastasis and a soft intersymphyseal bar. After osteotomy, all children were maintained in external ®xation and lower-extremity traction for 6±8 weeks. Results Complications of osteotomy were limited to a partial femoral nerve palsy (one patient) and delayed union of fragments (one patient). Complications of BNR included urethral stricture (®ve patients) and bladder calculi (six patients). Continence results were modest, with 11 of 29 children (38%) dry during the day (dry interval >3 h) and eight of 29 (28%) dry at night. Eight children had daytime dry intervals of <3 h. The mean preoperative bladder capacity in children who were dry both day and night was 101 mL. Conclusions The preoperative bladder capacity remains a key determinant for the attainment of continence after BNR in the reconstruction of classic bladder exstrophy. Osteotomy allows pelvic closure and thus improves cosmesis of the mons and stabilizes the BNR in patients with a soft intersymphyseal bar, but seems to have no effect on continence when performed at the time of bladder neck plasty.

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Anterior Innominate Osteotomy in Repair of Bladder Exstrophy

Cited by 132 publications

References 10 publications

Osteotomia pélvica anterior bilateral para o fechamento de extrofia de bexiga: descrição de técnica

Osteotomia pélvica anterior bilateral para o fechamento de extrofia de bexiga: descrição de técnica

Tratamento da extrofia de bexiga: osteotomia posterior dos ossos ilíacos e fechamento da pelve com cinta de náilon

Bladder neck reconstruction in classic bladder exstrophy: the role of osteotomy in the development of continence

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