title: Loss of urethrovaginal septum as a complication of exstrophy closure in girls.
abstract: OBJECTIVE
  The aim of this study was to report complications involving paraexstrophy skin flaps in the female bladder exstrophy closure.
  
  
  METHODS
  Bladder exstrophies in three female patients were initially closed using paraexstrophy skin flaps, with an osteotomy being performed in only 1 patient. A dehiscence occurred in all, and a reclosure was performed at a mean of 10 (range: 7-18) months after the initial closure.
  
  
  RESULTS
  Two patients underwent successful reclosure and are awaiting bladder neck reconstruction. The third patient, who had complete procidentia, had a bladder which failed to grow after successful reclosure and underwent augmentation cystoplasty.
  
  
  CONCLUSIONS
  Closure of bladder exstrophy in female patients using paraexstrophy skin flaps can be associated with an increased complication rate and should be used judiciously in the exstrophy patient.
authors.affiliation: Department of Urology, James Buchanan Brady Urological Institute, Johns Hopkins Hospital, Baltimore, Md., USA.
authors.forename: J
authors.initials: J
authors.lastname: Ben-Chaim
authors.forename: R D
authors.initials: RD
authors.lastname: Jeffs
authors.forename: J P
authors.initials: JP
authors.lastname: Gearhart
mesh_terms: D001746:Bladder Exstrophy / Q000601:surgery*; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012086:Reoperation; D013524:Surgical Flaps / Q000009:adverse effects*; D013529:Surgical Wound Dehiscence / Q000209:etiology; D014522:Urethral Diseases / Q000209:etiology* / Q000601:surgery; D014548:Urinary Fistula / Q000209:etiology / Q000601:surgery; D013520:Urologic Surgical Procedures / Q000009:adverse effects*; D014623:Vaginal Diseases / Q000209:etiology* / Q000601:surgery; D014624:Vaginal Fistula / Q000209:etiology / Q000601:surgery