Modified VQZ-plasty for the creation of a catheterizable stoma suitable as a neoumbilicus in selected bladder exstrophy patients.
OBJECTIVE
To present a modified VQZ-plasty technique to create a catheterizable stoma appearing as a normal-looking neoumbilicus that may be used in selected bladder exstrophy (BE) patients.


METHODS
A catheterizable conduit is created according to the Mitrofanoff principle. An asymmetric V flap, with the base at the level selected as the upper margin of the neoumbilicus, is created and incorporated into the spatulated appendix. Then a Q flap is developed parallel to the shorter margin of the V flap, rotated, and anastomosed to the upper edge of the appendix and to the free margin of the V flap on the contralateral side. The skin gap is filled by a rotational flap overlying the emerging appendix and stoma site.


RESULTS
To date the technique has been used in 2 BE patients. After a follow-up of 10 and 6 months, respectively, both have good cosmetic and functional results, with an easily catheterizable stoma.


CONCLUSIONS
The described technique allows for the creation of a nearly ideal stoma that looks like a normal neoumbilicus in selected BE patients yet without an umbilicus and requiring the placement of a catheterizable conduit.
Berrettini
Alfredo
A
Department of Oncological and Surgical Sciences, Section of Pediatric Urology, Urology Unit, University Hospital of Padova, Padua, Italy.
Rigamonti
Waifro
W
Castagnetti
Marco
M
D001746:Bladder Exstrophy / Q000601:surgery*; D002648:Child; D003559:Cystostomy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D054047:Surgical Stomas; D014472:Umbilicus; D014546:Urinary Catheterization