Surgical reconstruction of exstrophy-epispadias complex: analysis of 13 patients.
BACKGROUND
Because exstrophy-epispadias complex is uncommon and satisfactory surgical reconstruction outcomes are difficult to achieve, the surgical repairs by one surgeon (PS) were analysed over a 14-year period.


METHODS
Retrospective analysis was performed on 13 patients with the complex who underwent surgery between January 1986 to August 2000. Cosmesis and continence were evaluated. Complications including wound dehiscence and urethrocutaneous fistula were reported.


RESULTS
Of six patients with classical exstrophy who underwent functional bladder closure, all had good cosmesis except one who had partial dehiscence. Four patients with isolated epispadias had satisfactory cosmesis. Urethrocutaneous fistula was found in one boy in the classical exstrophy group. Continence was achieved in three out of four patients who had bladder neck reconstruction. One girl whose bladder neck was severely obstructed after functional bladder closure, had continent catheterizable stoma.


CONCLUSIONS
Functional bladder closure yielded satisfactory cosmetic outcome. Bladder neck reconstruction made the patient dry in 75% of cases.
Sujijantararat
Phichaya
P
Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. sipsj@mahidol.ac.th
Chotivichit
Areesak
A
D000293:Adolescent; D001746:Bladder Exstrophy / Q000150:complications / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004842:Epispadias / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D013520:Urologic Surgical Procedures / Q000379:methods*