Complications of Exstrophy and Epispadias Surgery
Kevin R. Loughlin in Complications of Urologic Surgery and Practice, 2007
Bladder exstrophy is a complex anomaly involving the urinary, genital and intestinal tracts, and the musculoskeletal system. Typically, the diagnosis is made at newborn examination (Fig. 1B) or on fetal ultrasound performed by an experienced observer. Management of bladder exstrophy presents several challenges beginning with initial repair using either the more conventional approach of the modern staged repair of exstrophy (MSRE) or the complete primary repair of exstrophy (CPRE) technique. The MSRE consists of three specific, scheduled components. First, bladder, posterior urethra, and abdominal wall closure with bilateral innominate and vertical iliac osteotomy, when indicated, are performed in the newborn period. Secondly, epispadias repair is then performed at six months to one year of age. Thirdly, bladder neck reconstruction (BNR) and bilateral ureteral reimplantation are performed at age four to five years when adequate bladder capacity for BNR and motivation to participate in a postoperative voiding program are documented (1,2). Grady and Mitchell have described their technique of complete primary exstrophy repair (CPER) for single-stage reconstruction of bladder exstrophy (3,4). The goal of this technique is to combine the goals of staged reconstruction at a single operation; bladder closure and epispadias repair (4) with achievement of urinary continence, if possible, without formal BNR.
Bladder exstrophy and epispadias
Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg in Operative Pediatric Surgery, 2020
Contemporary estimates for the incidence of bladder exstrophy vary considerably. A recent international epidemiologic study placed the overall incidence at 2 per 100 000 births with a 2 : 1 male to female ratio. In the UK, the estimated incidence is 1 in 30 000 live births, with a 3 : 1 male preponderance. Primary epispadias has a similar male bias but is less common, with an incidence of 1 in 120 000. The surgical management of this rare group of anomalies is often concentrated in major surgical centres as in the UK, enabling the refinement of different surgical approaches.
Exstrophy-epispadias complex
J Kellogg Parsons, E James Wright in The Brady Urology Manual, 2019
Bladder exstrophy: Approximately 1 in 40 000 live births2MaleTemale ratio is approximately 2:13More common in whites than in other races.
Bladder Exstrophy Polyp: An Uncommon Entity in Surgical Pathology
Published in Fetal and Pediatric Pathology, 2022
Bladder exstrophy is a congenital malformation with a prevalence of 2.07 cases per 100,000 births [1,2]. It occurs in both genders with a slight male predominance (2:1) [2]. The occurrence of polyps in these bladders is relatively well-known to urologists. However, these polyps are not routinely sent for pathological examination. Therefore, such polyps could be a challenge to pathologists who are less familiar with this entity [1].
Complex maternal congenital anomalies – a rare presentation and delivery through a supra-umbilical abdominal incision
Published in Journal of Obstetrics and Gynaecology, 2018
Samantha Bonner, Yara Mohammed
Cloacal exstrophy is an extremely rare, complex malformation of the genital tract, affecting both males and females at 3–4:1 (Bildircin et al. 2012). Its estimated prevalence is 1 in 400,000 live births (Bildircin et al. 2012). With advances in reconstructive surgery, patients born with bladder exstrophy will face the reproductive challenges associated with their condition.
Related Knowledge Centers
- Birth Defect
- Bladder
- Levator Ani
- Mesoderm
- Pubic Symphysis
- Pelvic Floor
- Pelvis
- Urethra
- Vagina
- Cloacal Membrane