Document Detail


Complete primary repair of exstrophy.
MedLine Citation:
PMID:  10492227     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The surgical correction of bladder exstrophy to achieve continence with voiding remains a challenging problem for the urologist. Since 1989 we have performed complete primary repair for exstrophy based on the concept that the primary defect of bladder and cloacal exstrophy is anterior herniation. Thus, the bladder and urethra must be treated as a single unit to move them posteriorly into the pelvis. We present this technique. MATERIALS AND METHODS: From 1989 to 1997, 18 patients with bladder exstrophy and 6 with cloacal exstrophy underwent complete primary repair of exstrophy. This procedure was done on day 1 of life in 18 patients. Mean followup is 44 months (range 4 months to 8 years). RESULTS: At a median followup of 48 months 4 boys and 4 girls have volitional voiding after complete primary repair of bladder exstrophy, 21 patients have continent intervals and 2 boys void with continent intervals after complete primary repair of cloacal exstrophy. No patient has had a loss of renal function in this series. Postoperative complications included urethrocutaneous fistula formation in 2 cases. No patient had primary closure dehiscence. CONCLUSIONS: The rate of urinary continence achieved with complete primary repair compares favorably to that of staged repair for exstrophy. Complete primary repair also minimizes the number of surgical procedures required to achieve urinary continence and potentiates bladder neck function that permits bladder cycling in year 1 of life. The complication rates of these techniques are significantly lower than those reported in previous series of primary closure of exstrophy.
Authors:
R W Grady; M E Mitchell
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of urology     Volume:  162     ISSN:  0022-5347     ISO Abbreviation:  J. Urol.     Publication Date:  1999 Oct 
Date Detail:
Created Date:  1999-10-21     Completed Date:  1999-10-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1415-20     Citation Subset:  AIM; IM    
Affiliation:
Department of Urology, Children's Hospital and Regional Medical Center, Seattle, Washington, USA.
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MeSH Terms
Descriptor/Qualifier:
Bladder Exstrophy / surgery*
Female
Humans
Infant, Newborn
Male
Retrospective Studies
Urologic Surgical Procedures / methods*
Comments/Corrections
Comment In:
J Urol. 1999 Oct;162(4):1421-3   [PMID:  10492228 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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