title: Wire in the hole: a case series of eroded intrapubic wire sutures causing genitourinary complications in the bladder exstrophy complex.
abstract: Bladder exstrophy and cloacal exstrophy are rare congenital defects of the genitourinary tract that require complex surgical reconstruction. Malrotation of the bony pelvis causes a characteristic diastasis of the pubic symphysis, which is surgically reduced at the time of initial bladder closure. For a successful primary closure without tension such that the bladder can be placed deep within the pelvis, pelvic osteotomy is often used. However, alternative techniques have been utilized to bring the pubic rami into apposition. The authors present four bladder/cloacal exstrophy patients in which an intrapubic wire was used for pubic apposition, resulting in significant genitourinary complications.
authors.affiliation: Department of Urology, The James Buchanan Brady Urological Institute, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
authors.forename: Joan S
authors.initials: JS
authors.lastname: Ko
authors.forename: Angela D
authors.initials: AD
authors.lastname: Gupta
authors.forename: Heather N
authors.initials: HN
authors.lastname: Di Carlo
authors.forename: Kathy
authors.initials: K
authors.lastname: Lue
authors.forename: John P
authors.initials: JP
authors.lastname: Gearhart
mesh_terms: D001746:Bladder Exstrophy; D001864:Bone Wires / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D002988:Cloaca / Q000002:abnormalities; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods; D010384:Pelvic Bones / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D046548:Pubic Symphysis Diastasis / Q000209:etiology / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods; D012092:Replantation / Q000379:methods; D013537:Sutures / Q000009:adverse effects*; D016896:Treatment Outcome; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods