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Complications after primary bladder exstrophy closure - role of pelvic osteotomy.

Baka-Ostrowska M, Kowalczyk K, Felberg K, Wawer Z - Cent European J Urol (2013)

Bottom Line: It is observed in 1:30 000 life births, about four times more often in boys than in girls.Iliac osteotomy is used to facilitate bringing together pubic bones and to minimize the tension of fused elements.Posterior iliac osteotomy is sufficient and safe and could be repeated if necessary.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Urology of the Children's Memorial Health Institute, Warsaw, Poland.

ABSTRACT

Introduction: Bladder exstrophy is the most common form of the exstrophy - epispadias complex. It is observed in 1:30 000 life births, about four times more often in boys than in girls. Iliac osteotomy is used to facilitate bringing together pubic bones and to minimize the tension of fused elements. To analyze complications after primary bladder exstrophy closure with a special consideration of the role of pelvic osteotomy.

Material and method: It is a retrospective study evaluating 100 patients (chosen by chance out of 356) with bladder exstrophy (65 boys and 35 girls), treated in Pediatric Urology Department of the Children's Memorial Health Institute in Warsaw, Poland between 1982 and 2006. All children underwent primary bladder exstrophy closure, among them 32 elsewhere. Primary bladder exstrophy closure with contemporary iliac osteotomy was done in 36 children. In the rest 64 patients bladder was closed without osteotomy, regardless child's age.

Results: Dehiscence after primary closure followed with bladder prolaps occurred in 31 patients, among them 13 out of 68 (19%) operated in our department and 18 out of 32 (56%) operated in another hospital. Primary bladder exstrophy closure with contemporary iliac osteotomy was done in 32 infants above 72 hours of life.

Conclusions: Osteotomy performed at primary bladder exstrophy closure diminishes the risk of wound dehiscence independently of patient's age. Posterior iliac osteotomy is sufficient and safe and could be repeated if necessary.

No MeSH data available.


Related in: MedlinePlus

A girl with wound dehiscence after primary bladder exstrophy closure without osteotomy (a) and after secondary closure with posterior osteotomy (b).
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Figure 0005: A girl with wound dehiscence after primary bladder exstrophy closure without osteotomy (a) and after secondary closure with posterior osteotomy (b).

Mentions: Secondary bladder closure was performed at least one year after first operation. In all cases, re–operation was accompanied by posterior iliac osteotomy with seven cases with re–osteotomy among them. The surgical technique and immobilization period were the same in secondary and primary closure. Among the re–operated, there were 24 children aged one to two years and seven children over two years of age, including one four year old boy. There were no complications of osteotomy observed in either group with primary or secondary closure (Figs. 5 & 6).


Complications after primary bladder exstrophy closure - role of pelvic osteotomy.

Baka-Ostrowska M, Kowalczyk K, Felberg K, Wawer Z - Cent European J Urol (2013)

A girl with wound dehiscence after primary bladder exstrophy closure without osteotomy (a) and after secondary closure with posterior osteotomy (b).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3921855&req=5

Figure 0005: A girl with wound dehiscence after primary bladder exstrophy closure without osteotomy (a) and after secondary closure with posterior osteotomy (b).
Mentions: Secondary bladder closure was performed at least one year after first operation. In all cases, re–operation was accompanied by posterior iliac osteotomy with seven cases with re–osteotomy among them. The surgical technique and immobilization period were the same in secondary and primary closure. Among the re–operated, there were 24 children aged one to two years and seven children over two years of age, including one four year old boy. There were no complications of osteotomy observed in either group with primary or secondary closure (Figs. 5 & 6).

Bottom Line: It is observed in 1:30 000 life births, about four times more often in boys than in girls.Iliac osteotomy is used to facilitate bringing together pubic bones and to minimize the tension of fused elements.Posterior iliac osteotomy is sufficient and safe and could be repeated if necessary.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Urology of the Children's Memorial Health Institute, Warsaw, Poland.

ABSTRACT

Introduction: Bladder exstrophy is the most common form of the exstrophy - epispadias complex. It is observed in 1:30 000 life births, about four times more often in boys than in girls. Iliac osteotomy is used to facilitate bringing together pubic bones and to minimize the tension of fused elements. To analyze complications after primary bladder exstrophy closure with a special consideration of the role of pelvic osteotomy.

Material and method: It is a retrospective study evaluating 100 patients (chosen by chance out of 356) with bladder exstrophy (65 boys and 35 girls), treated in Pediatric Urology Department of the Children's Memorial Health Institute in Warsaw, Poland between 1982 and 2006. All children underwent primary bladder exstrophy closure, among them 32 elsewhere. Primary bladder exstrophy closure with contemporary iliac osteotomy was done in 36 children. In the rest 64 patients bladder was closed without osteotomy, regardless child's age.

Results: Dehiscence after primary closure followed with bladder prolaps occurred in 31 patients, among them 13 out of 68 (19%) operated in our department and 18 out of 32 (56%) operated in another hospital. Primary bladder exstrophy closure with contemporary iliac osteotomy was done in 32 infants above 72 hours of life.

Conclusions: Osteotomy performed at primary bladder exstrophy closure diminishes the risk of wound dehiscence independently of patient's age. Posterior iliac osteotomy is sufficient and safe and could be repeated if necessary.

No MeSH data available.


Related in: MedlinePlus