Total correction of bladder exstrophy - our experience in 37 patients

Abstract

All cases of exstrophy epispadias complex carried out in our centre between the period from February 1990 to December 1999. Total 37 cases of exstrophy epispadias complex were dealt with. Out of these, 30 cases under-went primary closure of bladder with or without oste-otomy. 7 babies had very small fibrotic patch bladder primarily or secondary to failed primary closure and they went on forpermanent diversion in the form of ileo-caecal bladder Out of 30 cases, 20 underwent Jeffs′ closure with os-teotomy and in 10 cases primary closure was done with-out osteotomy. In 19 patients we have completed all the stages of operation, that is, primary closure, epispadias repair and bladder neck reconstruction. The main problems in exstrophy bladder repair re-mained the, failure of bladder to heal, vesical fistula for-mation, development of inguinal hernia in postoperative stage. The dry interval period, following total correction of exstrophy bladder remains I to 2 hours with growing age. The children are in follow-up for 10 years now.

Keywords

• Exstrophy Epispadias Complex; Primary Closure of Bladder; Total Correction of Exstrophy