Primery bladder reconstruction with local fl aps in children with extrofy

Rudin Yu.E., Maruhnenko D.V., Chekeridi Yu.E.

Th e paper is dedicated to primary bladder reconstruction with local fl aps in children with exstrophy. An original method of bladder neck reconstruction with local fl aps with obligatory convergence of pubic bones in newborn infants has been proposed. 93 infants underwent surgery in the period from 1988 to 2009. Th e main group consisted of patients who underwent primary bladder reconstruction with local fl aps with convergence of the symphysis pubis bones (81). In 17 infants the procedure was supplied by the ileal osteotomy. Th e control group consisted of 12 children who underwent bladder area dissection with ureteral reimplantation into the colon. Long term outcomes of bladder exstrophy treatment were followed up within the period from 6 months to 18 years aft er surgery. Th e treatment results obtained were divided into 3 groups: good, satisfactory, unsatisfactory. In the main group good results were obtained in 80,2%; satisfactory results – in 12,3% and unsatisfactory – in 7,5% of patients. In the control group good results were obtained only in 33% of patients, satisfactory – in 33% of patients and unsatisfactory – in 33%. An application of original method of the bladder reconstruction with local fl aps with obligatory convergence of symphysis pubis bones enabled to achieve partial urine continence aft er fi rst stage of the surgery, to obtain well cosmetic result of plastic repair of anterior abdominal wall defect.