A combined vertical and horizontal pelvic osteotomy approach for primary and secondary repair of bladder exstrophy.
OBJECTIVE
We describe a new combined horizontal and vertical pelvic osteotomy procedure for bladder exstrophy.


METHODS
A total of 36 patients with the bladder exstrophy complex underwent this procedure during a 3-year period (8 primary and 18 secondary bladder closures, and 6 at bladder neck reconstruction).


RESULTS
There were no instances of dehiscence and only a minor bladder prolapse in 1 patient with cloacal exstrophy. Two patients had a transient femoral nerve palsy and there was 1 superficial pin infection. Urological complications included symptomatic urinary tract infections in 5 patients, acute epididymitis in 1 and bladder calculi in 2.


CONCLUSIONS
This new osteotomy procedure is of great benefit in initial or repeat closure of bladder exstrophy and may help in eventually achieving continence.
Gearhart
J P
JP
Department of Urology, James Buchanan Brady Urological Institute, Johns Hopkins Hospital, Baltimore, Maryland 21287-2101, USA.
Forschner
D C
DC
Jeffs
R D
RD
Ben-Chaim
J
J
Sponseller
P D
PD
D001746:Bladder Exstrophy / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010027:Osteotomy / Q000379:methods*; D010384:Pelvic Bones / Q000601:surgery; D012086:Reoperation