Complications of radical soft-tissue mobilization procedure as a primary closure of exstrophy.

Published

Journal Article

PURPOSE: The radical soft-tissue mobilization procedure was developed as a component of the staged closure of classical bladder exstrophy to improve continency rates without having to perform pelvic osteotomies. The authors describe complications following this procedure and discuss possible etiologies and subsequent management. MATERIALS AND METHODS: We extracted from an institutionally approved exstrophy database the records of patients evaluated for complications following radical soft-tissue mobilization repair from 1999 to 2002. RESULTS: Four patients were referred to our institution following closure of exstrophy with the radical soft-tissue mobilization technique; two boys and two girls. Complications included ischemic penile injuries in both males, failed exstrophy closure in one female, incontinence with need for bladder neck transection and diversion in two patients, and upper tract deterioration in two patients of whom one required cystectomy and incontinent diversion. CONCLUSIONS: Omission of osteotomies when employing the radical soft-tissue mobilization repair appears to result in complications that could otherwise be prevented. Additionally, the complex dissection of the pelvic musculature, innervation and vasculature performed during radical mobilization has great potential to injure the pelvic structures and genitalia, as has been seen with the cases presented herein.

Full Text

Duke Authors

Cited Authors

  • Purves, JT; Gearhart, JP

Published Date

  • February 2008

Published In

Volume / Issue

  • 4 / 1

Start / End Page

  • 65 - 69

PubMed ID

  • 18631895

Pubmed Central ID

  • 18631895

Electronic International Standard Serial Number (EISSN)

  • 1873-4898

Digital Object Identifier (DOI)

  • 10.1016/j.jpurol.2007.02.006

Language

  • eng

Conference Location

  • England