Initial Experiences of Complete Primary Exstrophy Repair in Cloacal and Bladder Exstrophy

Taejin Kang; Chang Hee Yoo; Kun Suk Kim

doi:10.4111/kju.2006.47.3.334

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Kang, Yoo, and Kim: Initial Experiences of Complete Primary Exstrophy Repair in Cloacal and Bladder Exstrophy

Case Report

Korean Journal of Urology

Korean Journal of Urology 2006; 47(3): 334-340.

Published online: 31 March 2006

DOI: https://doi.org/10.4111/kju.2006.47.3.334

Initial Experiences of Complete Primary Exstrophy Repair in Cloacal and Bladder Exstrophy

Taejin Kang, Chang Hee Yoo, Kun Suk Kim

Department of Urology, University of Ulsan College of Medicine, Seoul, Korea.

Corresponding author (kskim2@amc.seoul.kr)

Received 27 September 2005 Accepted 9 November 2005

Abstract

We report here the short-term results of 3 cases of cloacal and bladder exstrophy that underwent complete primary exstrophy repair. One case was diagnosed as bladder exstrophy and the others were diagnosed as cloacal exstrophy. Complete primary exstrophy repair for all 3 cases was carried out within 24 hours after birth. There was no wound dehiscence within the follow-up period of 12 months. The complete primary exstrophy repair with positioning the bladder neck and urethra in the deep pelvic cavity achieves a satisfactory short-term result.

Keywords: Bladder exstrophy, Cloaca, Reconstructive surgical procedures

Figures and Tables

Fig. 1

The preoperative findings and illustration of case 1.

Fig. 2

Intraoperative procedures of complete primary exstrophy repair. (A) Dissection of the exstrophied bladder from the abdominal wall. (B) Primary repair of the bladder and urethra. (C) Proper positioning of the bladder neck and the proximal urethra within the pelvic diaphragm and closure of the symphysis pubis. (D) Immediate postoperative findings.

Fig. 3

The preoperative findings and illustration of case 2.

Fig. 4

Intraoperative procedures. (A) Dissection of exstrophied cloaca from the abdominal wall. (B) Deep positioning of the bladder neck and the proximal urethra within the pelvic diaphragm and closure of the symphysis pubis. (C) The postoperative photograph at 6 months.

Fig. 5

The preoperative findings and illustration of case 3.

Fig. 6

Immediate postoperative findings.

Table 1

Summary of cases

CPER: complete primary exstrophy repair, VUR: vesicoureteral reflux

References

1. Lee DH, Kim KS. Bladder exstrophy with successful initial closure. Korean J Urol. 2001. 42:1125–1129.

2. Lee KS, Lee JZ, Pak YH, Yoon JB. The experiences of clocal and bladder exstrophy: 3 cases. Korean J Urol. 1994. 35:793–800.

3. Noh JH, Jeong HJ, Kwon DD, Ryu SB, Park YI. A case of urethral construction using paraexstrophy flap in newborn female with classical exstrophy. Korean J Urol. 1998. 39:293–296.

4. Grady RW, Carr MC, Mitchell ME. Complete primary closure of bladder exstrophy: epispadias and bladder exstrophy repair. Urol Clin North Am. 1999. 26:95–109.

5. Mitchell ME. Bladder exstrophy repair: complete primary repair of exstrophy. Urology. 2005. 65:5–8.

6. Shaw MB, Rink RC, Kaefer M, Cain MP, Casale AJ. Continence and classic bladder exstrophy treated with staged repair. J Urol. 2004. 172:1450–1453.

7. Lund DP, Hendren WH. Cloacal exstrophy: experience with 20 cases. J Pediatr Surg. 1993. 28:1360–1368.

8. Ransley P. The ultimate challenge of cloacal exstrophy. J Urol. 2002. 167:300–304.

9. Reilly J, Woodhouse CR. Small penis and the male sexual role. J Urol. 1989. 142:569–571.

10. Reiner W. Sex assignment in the neonate with intersex or inadequate genitalia. Arch Pediatr Adolesc Med. 1997. 151:1044–1045.

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