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The use of bladder neck reconstruction in bladder exstrophy.
MedLine Citation:
PMID:  21453852     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
A major goal of bladder exstrophy (BE) management is achieving urinary continence, most commonly with surgical bladder neck reconstruction (BNR). This is a report of outcome of BNR after complete primary repair of exstrophy (CPRE). At our institution, patient history, ultrasound, cystogram (VCUG) and urodynamic study (UDS) were performed during a prospective evaluation of patients with BE. Dry interval of >3 hours was used as the definition of continence and dry interval <1-hour incontinence. Bladder capacity was measured at VCUG and/or UDS. UDS was also used to assess bladder compliance. From 1994 to 2010, we cared for 47 BE patients (31 male, 15 female) after CPRE. For patients ≥3 years after CPRE, BNR was performed in 9 of 22 (41%) male and 3 of 11 (27%) female patients. Mean age at BNR was 6.3 and 5.9 years for male and female patients, respectively. The mean (±SD) bladder capacity pre-BNR was 104.8 (±20.4 mL). There was a significant increase in capacity from pre-BNR to ≥1.5 years post-BNR (P = 0.013) and from <1.5 and ≥1.5 years post-BNR (P = 0.002). In conclusion, most patients with BE require BNR after CPRE. The need for BNR is more common in male patients.
Authors:
Joseph G Borer
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Seminars in pediatric surgery     Volume:  20     ISSN:  1532-9453     ISO Abbreviation:  Semin. Pediatr. Surg.     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9216162     Medline TA:  Semin Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  91-6     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
Department of Surgery (Urology), Harvard Medical School and Assistant in Urology, Children's Hospital Boston, Boston, Massachusetts.
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