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J Pediatr Urol. 2009 Jun;5(3):186-9. doi: 10.1016/j.jpurol.2008.11.005. Epub 2009 Mar 28.

Our initial experience with the technique of complete primary repair for bladder exstrophy.

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  • 1Department of Pediatric Urology, University of Oklahoma Health Science Center, 920 Stanton L. Young Blvd. WP 3150, Oklahoma City, OK 73104, USA. Yusuf-kibar@ouhsc.edu

Abstract

OBJECTIVE:

We reviewed our initial results with complete primary repair of exstrophy in regard to continence status and the need for subsequent continence procedures.

PATIENTS AND METHODS:

We performed a retrospective review of our surgical records from 1996 to 2008 to identify all patients with bladder exstrophy managed at our center.

RESULTS:

Sixteen children were closed successfully. Six patients (37.5%) experienced complications: umbilical hernias in two, transient penopubic fistula in three, and subcoronal fistula due to meatal stenosis in one. Of the 12 males, seven (58.3%) were left with a hypospadias at the time of primary closure. Two (22.2%) children required a formal bladder neck reconstruction to achieve continence. Bladder augmentation and continent catheterizable stoma was performed in four cases (44.4%), and bladder neck injection in one case (11.1%). Bladder neck closure was also performed in another child following primary closure. Three of these children are continent and void spontaneously (33.3%). The remaining six require clean intermittent catheterization four to six times a day, resulting in four (44.4%) being continent. The number of continence procedures and mean number per patient were 15 and 1.66, respectively.

CONCLUSION:

Our early experience with this technique has been encouraging, with few major complications, a highly successful closure rate and a cosmetically normal result.

PMID:
19329363
[PubMed - indexed for MEDLINE]
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