Perioperative management of classic bladder exstrophy

Abstract

Eric Z Massanyi,1 John P Gearhart,1 Sabine Kost-Byerly2 1Division of Pediatric Urology, Department of Urology, James Buchanan Brady Urological Institute, 2Division of Pediatric Anesthesia, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Hospital and Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA Abstract: The exstrophy-epispadias complex is a rare congenital malformation of the genitourinary system, abdominal wall muscles, and pelvic structures. Modern surgical repairs focus on reconstruction of the bladder and its adjacent structures, with the goal of achieving urinary continence, a satisfactory cosmetic result, and a high quality of life. Complex surgery in neonates and young children, as well as a prolonged postoperative course require close collaboration between surgeons, anesthesiologists, intensivists, pediatricians, and an experienced nursing staff. This article will review the spectrum of bladder exstrophy anomalies, the surgical repair, and the perioperative interdisciplinary management. Keywords: bladder exstrophy, infant, newborn, surgery, anesthesia