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Complications of primary closure of classic bladder exstrophy.

Publication ,  Journal Article
Schaeffer, AJ; Purves, JT; King, JA; Sponseller, PD; Jeffs, RD; Gearhart, JP
Published in: J Urol
October 2008

PURPOSE: We report the urological, orthopedic and neurological complications of primary closure of classic bladder exstrophy using modern staged repair of exstrophy. MATERIALS AND METHODS: An approved database identified 137 males and 57 females with classic bladder exstrophy who underwent primary repair by 1 of 2 surgeons in 23 years. A total of 185 patients underwent primary closure using modern staged repair of exstrophy with or without osteotomies, whereas 9 underwent delayed primary closure with epispadias repair at age 12 months. Of the patients 63 received osteotomies. Mean age at closure was 60 days and mean followup was 9 years. RESULTS: There were 14 major complications (11%) and 27 minor complications (14%). Major urological complications included bladder prolapse or dehiscence in 6 male patients (3%), which was successfully reclosed. Major orthopedic complications, including osteotomy nonunion in 2 cases, leg length inequality in 1 and persistent joint pain in 1, developed in 4 of the 63 patients (6%) who underwent osteotomy. Major neurological complications included femoral nerve palsy in 4 patients (2%). There were 21 minor urological complications (11%), including posterior bladder outlet obstruction in 4 cases, urethrocutaneous fistula in 2, suprapubic tube removal in 2, intrapubic stitch erosion in 4, febrile urinary tract infection in 6 and surgical site infection in 3. Six patients (3%) had minor orthopedic complications, including pelvic osteomyelitis in 1, pin site infection in 3 and a pressure sore from immobilization in 1. CONCLUSIONS: Closure of bladder exstrophy is a safe surgery with an acceptable risk of complications. A critical review of outcomes provides insight to further refine the technique and manage complications when they develop.

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Published In

J Urol

DOI

EISSN

1527-3792

Publication Date

October 2008

Volume

180

Issue

4 Suppl

Start / End Page

1671 / 1674

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Urologic Surgical Procedures
  • Urinary Bladder Neck Obstruction
  • Surgical Wound Dehiscence
  • Postoperative Complications
  • Pelvic Bones
  • Osteotomy
  • Male
  • Infant
  • Humans
 

Citation

APA
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ICMJE
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Schaeffer, A. J., Purves, J. T., King, J. A., Sponseller, P. D., Jeffs, R. D., & Gearhart, J. P. (2008). Complications of primary closure of classic bladder exstrophy. J Urol, 180(4 Suppl), 1671–1674. https://doi.org/10.1016/j.juro.2008.03.100
Schaeffer, Anthony J., J Todd Purves, Jeremy A. King, Paul D. Sponseller, Robert D. Jeffs, and John P. Gearhart. “Complications of primary closure of classic bladder exstrophy.J Urol 180, no. 4 Suppl (October 2008): 1671–74. https://doi.org/10.1016/j.juro.2008.03.100.
Schaeffer AJ, Purves JT, King JA, Sponseller PD, Jeffs RD, Gearhart JP. Complications of primary closure of classic bladder exstrophy. J Urol. 2008 Oct;180(4 Suppl):1671–4.
Schaeffer, Anthony J., et al. “Complications of primary closure of classic bladder exstrophy.J Urol, vol. 180, no. 4 Suppl, Oct. 2008, pp. 1671–74. Pubmed, doi:10.1016/j.juro.2008.03.100.
Schaeffer AJ, Purves JT, King JA, Sponseller PD, Jeffs RD, Gearhart JP. Complications of primary closure of classic bladder exstrophy. J Urol. 2008 Oct;180(4 Suppl):1671–1674.
Journal cover image

Published In

J Urol

DOI

EISSN

1527-3792

Publication Date

October 2008

Volume

180

Issue

4 Suppl

Start / End Page

1671 / 1674

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Urologic Surgical Procedures
  • Urinary Bladder Neck Obstruction
  • Surgical Wound Dehiscence
  • Postoperative Complications
  • Pelvic Bones
  • Osteotomy
  • Male
  • Infant
  • Humans