title: The 3-loop technique: a reliable technique for anterior pubic fixation in bladder exstrophy.
abstract: OBJECTIVE
  In exstrophic anomalies the ultimate urological outcome largely depends on successful initial closure of the lower urinary tract and soft tissues. We believe that secure anterior pubic fixation is crucial for ensuring successful closure. After being dissatisfied with other methods of anterior pubic fixation we introduced the 3-loop method. The 3-loop technique and our experience with it are described.
  
  
  METHODS
  In 2 years 7 consecutive cases of bladder exstrophy were closed using the 3-loop technique. Patient age at closure ranged from newborn to 9 years.
  
  
  RESULTS
  In all 7 patients closure was successful and there was no cutting through of the wires, bony erosion, or erosion into the reconstructed bladder neck or urethra. The duration of postoperative traction was only 2 weeks.
  
  
  CONCLUSIONS
  The 3-loop method is useful and reliable for secure anterior pubic fixation of the pubes in bladder exstrophy patients and it contributes positively to the ultimate urological outcome.
authors.affiliation: Department of Pediatric Surgery, Lokmanya Tilak Municipal General Hospital, Bombay, India.
authors.forename: S J
authors.initials: SJ
authors.lastname: Karmarkar
authors.forename: J V
authors.initials: JV
authors.lastname: Patankar
authors.forename: S N
authors.initials: SN
authors.lastname: Oak
authors.forename: R H
authors.initials: RH
authors.lastname: Ramadwar
authors.forename: B K
authors.initials: BK
authors.lastname: Kulkarni
authors.forename: S S
authors.initials: SS
authors.lastname: Deshmukh
mesh_terms: D001746:Bladder Exstrophy / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008722:Methods; D011630:Pubic Bone; D016896:Treatment Outcome