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Abstract
Classic bladder exstrophy is a rare malformation of the genitourinary tract. The surgical management of bladder exstrophy has evolved significantly during the last 50 years but successful reconstruction for this condition remains a major challenge in pediatric urology. The ideal reconstruction of the child with classic bladder exstrophy would establish urinary continence with normal bladder dynamics and provide normal genital cosmoses all with preservation of upper urinary tract function.
The aim of this study is to evaluate our experience at our center (pediatric unit of urology department Cairo University) in exstrophy repair by different techniques & strategies in different age groups. Comparison of our results of these different techniques & strategies in different age groups with the literature is important to establish the basis of better management and to provide better health service to those children suffering from this complex congenital anomaly.
During the period between January 2000 and January 2007 we retrospectively studied patients presenting with bladder exstrophy at our center. During this period we treated 52 patients (17 females and 35 males) suffering from classic bladder exstrophy complex. Age of presentation ranged from 24 hours to 14 months. 42 patients underwent complete primary exstrophy repair and 10 patients were staged.
The results showed preservation of the upper tract in most of our patients with no severe upper tract changes. Continence results were comparable to some centers; however we had a higher rate of failure of successful primary closure.
We recommend doing a prospective study, standardization of the technique, protocol, and surgical team.