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• W2089323218 abstract "No AccessJournal of UrologyBladder Reconstruction/Transplantation1 Jun 2011Bladder Neck Reconstruction is Often Necessary After Complete Primary Repair of Exstrophy Patricio Gargollo, W. Hardy Hendren, David A. Diamond, Melanie Pennison, Rosemary Grant, Ilina Rosoklija, Alan B. Retik, and Joseph G. Borer Patricio GargolloPatricio Gargollo More articles by this author , W. Hardy HendrenW. Hardy Hendren More articles by this author , David A. DiamondDavid A. Diamond More articles by this author , Melanie PennisonMelanie Pennison More articles by this author , Rosemary GrantRosemary Grant More articles by this author , Ilina RosoklijaIlina Rosoklija More articles by this author , Alan B. RetikAlan B. Retik More articles by this author , and Joseph G. BorerJoseph G. Borer More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.01.024AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: A major goal of bladder exstrophy management is urinary continence, often using bladder neck reconstruction. We report our experience with bladder neck reconstruction after complete primary repair of exstrophy. Materials and Methods: Patient history, ultrasound, voiding cystourethrogram, examination using anesthesia and urodynamics were performed during a prospective evaluation. Continence was assessed using the International Children's Continence Society classification and the dry interval. Bladder capacity was measured by examination using anesthesia, voiding cystourethrogram and/or urodynamics. Urodynamics were also done to assess bladder compliance and detrusor muscle function. Results: From 1994 to 2010 we treated 31 male and 15 female patients with bladder exstrophy after complete primary repair of exstrophy. Of patients 5 years old or older bladder neck reconstruction was performed after complete primary repair in 9 of 21 males (43%) and in 3 of 11 females (27%) at a mean age of 6.3 and 8.1 years, respectively. By the International Children's Continence Society classification 6 of 12 patients (50%) were continent less than 1.5 years after bladder neck reconstruction and 2 of 9 (23%) were evaluable 1.5 years or greater after reconstruction. Median bladder capacity was 100 ml before, 50 ml less than 1.5 years after and 123 ml 1.5 years or greater after bladder neck reconstruction. Three males and 2 females emptied via an appendicovesicostomy. Two boys underwent augmentation. Conclusions: In our experience most patients with bladder exstrophy require bladder neck reconstruction after complete primary repair of exstrophy. The need for reconstruction is more common in males. Our rates of bladder neck reconstruction after complete primary repair of exstrophy and of continence after bladder neck reconstruction are similar to those in other reports. References 1 : The staged approach to bladder exstrophy closure and the role of osteotomies. World J Urol1998; 16: 205. Google Scholar 2 : Newborn exstrophy closure and epispadias repair. World J Urol1998; 16: 200. Google Scholar 3 : Bladder growth and development after complete primary repair of bladder exstrophy in the newborn with comparison to staged approach. J Urol2005; 174: 1553. Link, Google Scholar 4 : Long-term followup of complete primary repair of exstrophy: the Seattle experience. J Urol2008; 180: 1615. Link, Google Scholar 5 : Results of bladder neck reconstruction after newborn complete primary repair of exstrophy. J Urol2007; 178: 1619. Link, Google Scholar 6 : Outcome of complete primary bladder exstrophy repair: single-center experience. 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Link, Google Scholar 14 : Trans-appendicular continent cystostomy in the management of the neurogenic bladder. Chir Pediatr1980; 21: 297. Google Scholar 15 : Improved results using a modification of the Young-Dees-Leadbetter bladder neck repair. Br J Urol1993; 71: 555. Google Scholar 16 : Long-term results of bladder neck reconstruction for incontinence in children with classical bladder exstrophy or incontinent epispadias. BJU Int2003; 92: 997. Google Scholar 17 : How well do patients with exstrophy actually void?. J Urol2000; 164: 1044. Link, Google Scholar Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts© 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byMaruf M, Manyevitch R, Michaud J, Jayman J, Kasprenski M, Zaman M, Benz K, Eldridge M, Trock B, Harris K, Wu W, Di Carlo H and Gearhart J (2019) Urinary Continence Outcomes in Classic Bladder Exstrophy: A Long-Term PerspectiveJournal of Urology, VOL. 203, NO. 1, (200-205), Online publication date: 1-Jan-2020.Borer J, Vasquez E, Canning D, Kryger J and Mitchell M (2015) An Initial Report of a Novel Multi-Institutional Bladder Exstrophy Consortium: A Collaboration Focused on Primary Surgery and Subsequent CareJournal of Urology, VOL. 193, NO. 5S, (1802-1807), Online publication date: 1-May-2015.Lloyd J, Spano S, Ross S, Wiener J and Routh J (2018) How Dry is Dry? A Review of Definitions of Continence in the Contemporary Exstrophy/Epispadias LiteratureJournal of Urology, VOL. 188, NO. 5, (1900-1904), Online publication date: 1-Nov-2012. Volume 185Issue 6SJune 2011Page: 2563-2571 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Keywordsbladder exstrophyurinary bladderreconstructive surgical proceduresurinary incontinenceabnormalitiesMetricsAuthor Information Patricio Gargollo More articles by this author W. Hardy Hendren More articles by this author David A. Diamond More articles by this author Melanie Pennison More articles by this author Rosemary Grant More articles by this author Ilina Rosoklija More articles by this author Alan B. Retik More articles by this author Joseph G. Borer More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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