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Journal articles on the topic 'EXSTROPHY'

Author: Grafiati

Published: 1 April 2023

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1

Thapa, Bijay. "Duplicate Bladder Exstrophy With Fistula: A Rare Variant of Exstrophy-Epispadias Complex." Journal of Nepal Paediatric Society 41, no. 2 (November 3, 2021): 282–85. http://dx.doi.org/10.3126/jnps.v41i2.30752.

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Variants of exstrophy are rare anomalies seen in the spectrum of bladder exstrophy-epispadias complex. A seven day old male neonate was admitted in our department with a rare variant of duplicate bladder communicating with exstrophy bladder with fistula. Patient presented with patch of exstrophic bladder just below the low set umbilicus with a normal sized phallus and normally positioned urethral meatus. The baby was managed successfully with surgery and is under regular follow up.

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2

Ben-Chaim, Jacob, Steven G. Docimo, Robert D. Jeffs, and John P. Gearhart. "Bladder Exstrophy from Childhood into Adult Life." Journal of the Royal Society of Medicine 89, no. 1 (January 1996): 39P—46P. http://dx.doi.org/10.1177/014107689608900112.

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Exstrophy of the bladder is rare and the incidence of bladder exstrophy is calculated to be from 1 per 30 000 to 50 000 live births with male to female ratio ranging from 1.5-5 to 1 1-4 It was found that persistence or overgrowth of the cloacal membrane on the lower anterior abdominal area, prevents normal mesenchymal ingrowth. This causes divergence of the lower abdominal muscular structures and forces the genital ridges to fuse caudal to the cloacal membrane. The stage of ingrowth of the urorectal septum at the time of rupture determines whether one will produce an exstrophic urinary tract alone (classic bladder exstrophy or epispadias) or cloacal exstrophy with the hindgut interposed between the hemibladders5,6.

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3

Ahmed and Abu Daia. "Exstrophic abdominal wall defect without bladder exstrophy (pseudo-exstrophy)." BJU International 81, no. 5 (May 1998): 762–63. http://dx.doi.org/10.1046/j.1464-410x.1998.00584.x.

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4

van der Putte, S. C. J., W. G. M. Spliet, and P. G. J. Nikkels. "Common (“Classical”) and Covered Cloacal Exstrophy: A Histopathological Study and a Reconstruction of the Pathogenesis." Pediatric and Developmental Pathology 11, no. 6 (November 2008): 430–42. http://dx.doi.org/10.2350/07-06-0292.1.

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Current opinion about structure and pathogenesis of cloacal exstrophy was challenged by histopathological findings and new insights into the normal development. Autopsy specimens of common ( n = 3) and covered cloacal exstrophy ( n = 4) with single intraexstrophic and -perineal phallic structures and perineo-exstrophic canals have been analyzed histopathologically. The findings were correlated to normal development to reconstruct the pathogenesis. By identifying a specific cloaca-derived urethra field as distinct from allantois-derived bladder fields, the exstrophic area is found to reflect the original hindgut configuration in embryos of approximately 26–29 postovulatory days gestational age (2–4 mm). Correlation to normal development suggests malfunctioning of the primitive streak/caudal eminence as a primary fault that leads to a defective cloacal region in the hindgut disturbing cloacal-intestinal-allantoic dissociation and also causes lengthening of the intestinal region into a blind-ending colon, teratoma-like lesions, and vertebral and muscular anomalies. The current idea that membranes in “covered cloacal exstrophy” represent persisting cloacal membranes is dismissed by finding an amnion-like structure, which suggests dysfunction of an umbilical ring placode as a simultaneous 2nd fault. This malfunctioning may cause omphalocele by defective demarcation of the umbilical cord and may replace midline stroma of the infraumbilical abdominal wall by extraembryonic tissue that stretches into a weak temporary membrane, may leave a perineo-extrophic canal, and may allow the formation of a single perineal or intraexstrophic phallus. Malfunctioning without replacement may result in a purely epithelial “allantoic” membrane, which by disintegrating in combination with the cloacal membrane will expose common cloacal exstrophy.

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5

Ganarin, Alba, Michele Corroppolo, Giosuè Mazzero, Clara Revetria, Fabio Beretta, and Enrico Ciardini. "Exstrophy-Epispadias Complex Variants: A Hybrid Case." Pediatric Reports 13, no. 2 (April 7, 2021): 177–80. http://dx.doi.org/10.3390/pediatric13020024.

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The term exstrophy-epispadias complex refers to a group of midline defects ranging from epispadias to cloacal exstrophy. Bladder exstrophy is the most frequent malformation of this spectrum and it can present as a classical or a variant form. We report a case of a hybrid bladder exstrophy variant having some characteristics of both a duplicate bladder exstrophy and a superior vesical fistula.

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6

Inouye, Brian M., Ali Tourchi, Heather N. Di Carlo, Ezekiel E. Young, and John P. Gearhart. "Modern Management of the Exstrophy-Epispadias Complex." Surgery Research and Practice 2014 (2014): 1–9. http://dx.doi.org/10.1155/2014/587064.

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The exstrophy-epispadias complex is a rare spectrum of malformations affecting the genitourinary system, anterior abdominal wall, and pelvis. Historically, surgical outcomes were poor in patients with classic bladder exstrophy and cloacal exstrophy, the two more severe presentations. However, modern techniques to repair epispadias, classic bladder exstrophy, and cloacal exstrophy have increased the success of achieving urinary continence, satisfactory cosmesis, and quality of life. Unfortunately, these procedures are not without their own complications. This review provides readers with an overview of the management of the exstrophy-epispadias complex and potential surgical complications.

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7

Thakkar, Nirali Chirag, Prince Raj, and Yogesh Kumar Sarin. "Antero-posterior Duplicate Exstrophy with a Wet Bladder Plate: A Diagnostic Dilemma." Journal of Neonatal Surgery 5, no. 3 (July 1, 2016): 37. http://dx.doi.org/10.21699/jns.v5i3.369.

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Variants of exstrophy are rare anomalies seen in the spectrum of bladder exstrophy-epispadias complex. We present a rare case of duplicate exstrophy with a wet bladder plate. This is a deviation from the classical description of antero-posterior duplicate exstrophy that is associated with a dry bladder plate.

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8

Patil, Prashant Sadashiv, Paras Kothari, Abhaya Gupta, Rahul Gupta, Geeta Kekre, Vishesh Dikshit, and Ravi Kamble. "Cloacal Exstrophy with Mature Teratoma: A Rare Association in a Neonate." Journal of Neonatal Surgery 5, no. 2 (March 13, 2016): 17. http://dx.doi.org/10.47338/jns.v5.284.

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Cloacal exstrophy is a very rare and complex malformation. We report a neonate of cloacal exstrophy with mature teratoma presenting as a component of exstrophy. To our knowledge this has not been reported in the literature.

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9

Aboushaer, Mohamed B., and Noura M. Almutairi. "Cloacal exstrophy misdiagnosed as bladder exstrophy." Journal of Pediatric Surgery Case Reports 56 (May 2020): 101425. http://dx.doi.org/10.1016/j.epsc.2020.101425.

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10

Vilanova-Sánchez, Alejandra, Christina Ching, Alessandra Gasior, Karen Diefenbach, Richard Wood, and Marc Levitt. "Image of the Month: Clinical Features in a Newborn with Covered Cloacal Exstrophy." European Journal of Pediatric Surgery Reports 05, no. 01 (January 2017): e57-e59. http://dx.doi.org/10.1055/s-0037-1606389.

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AbstractCloacal exstrophy is the most severe type of anorectal malformations that belongs to the bladder–exstrophy–epispadias complex of genitourinary malformations. Interestingly, its variant, the covered cloacal exstrophy, is often missed. The clinical findings of this variant may include an imperforate anus, low lying umbilicus, thick pubic bone, and pubic diastasis but with an intact abdominal wall. We present an interesting case of covered cloacal exstrophy with a side-by-side duplicated bladder and discuss important considerations for the time of colostomy creation in the newborn period.

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11

Varygin, Vitalij, Šarūnas Bernotas, Pranas Gurskas, Valerijus Karmanovas, Sigitas Strupas, Olga Zimanaitė, and Gilvydas Verkauskas. "Cloacal Exstrophy: A Case Report and Literature Review." Medicina 47, no. 12 (January 3, 2012): 100. http://dx.doi.org/10.3390/medicina47120100.

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Cloacal exstrophy is an extremely rare congenital malformation resulting in an exstrophy of the urinary, intestinal, and genital organs and associated with anomalies of other organ systems. We present a complicated case of cloacal exstrophy and the recent progress in the management of this probably most complicated anomaly in pediatric urology and surgery.

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12

Hyun, Susanne Jane. "Cloacal Exstrophy." Neonatal Network 25, no. 2 (March 2006): 101–15. http://dx.doi.org/10.1891/0730-0832.25.2.101.

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Cloacal exstrophy is an extremely rare and devastating complex of congenital abnormalities resulting in multiple debilitating morbidities. Infants with this disorder require numerous surgical interventions to repair gastrointestinal, genitourinary, spinal, and orthopedic malformations. Treatment involves the combined efforts of many medical and nursing specialists. This article discusses the embryology, clinical presentation, and management (both early and long term) of cloacal exstrophy, with emphasis on gender reassignment issues and quality of life.

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13

Smith, Caitlin A., Jeffrey R. Avansino, Paul Merguerian, Victoria Lane, and Marc Levitt. "A Novel Surgical Approach for the Management of Cloacal Exstrophy with a Giant Omphalocele." European Journal of Pediatric Surgery Reports 09, no. 01 (January 2021): e41-e45. http://dx.doi.org/10.1055/s-0041-1728719.

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AbstractCloacal exstrophy is a rare malformation that presents as a lower midline abdominal wall defect which affects the gastrointestinal and genitourinary systems. The components of cloacal exstrophy characteristically include omphalocele, exstrophy of perineal structures, and imperforate anus. Most of these patients also have renal anomalies such as pelvic kidney, fused kidneys, or solitary kidneys. This congenital condition can also be associated with spinal issues, such as spinal dysraphism. When combined with spinal defects, it is referred to as the omphalocele, exstrophy, imperforate anus, and spinal defects (OEIS) complex, and is one of the most challenging surgical conditions to manage. Here, we present a unique case of a low-birth-weight patient with OEIS and a liver containing giant omphalocele and the novel surgical technique used to manage her cloacal exstrophy whereby the cecal plate was not separated from the bladder halves, but rather left for an autoaugment, and the ileum was connected to the hindgut.

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14

Narasimharao, K. L., R. S. Chana, S. K. Mitra, and I. C. Pathak. "Covered Exstrophy and Visceral Sequestration: A Rare Exstrophic Variant." Journal of Urology 133, no. 2 (February 1985): 274–75. http://dx.doi.org/10.1016/s0022-5347(17)48915-4.

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15

Ali, Rao Nouman, Khalid Hussain, Hassam Khalid, Zain Yasin, and Attiq-ur Rehman. "A case report on continent isolated male epispadias." Professional Medical Journal 27, no. 06 (June 10, 2020): 1320–22. http://dx.doi.org/10.29309/tpmj/2020.27.06.3899.

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Epispadias is a rare congenital anomaly in which the urethral opening is on the dorsal surface of penis. Its incidence is 1 in 117000 newborn males and 1 in 484000 in newborn females. Its etiology is considered as because of failure of medial migration of mesenchyme between the ectodermal and endodermal layers of cloacal membrane due to premature rupture of cloacal membrane. Epispadias often presents as exstrophy epispadias complex, a wide spectrum of abnormalities that consist of classic bladder exstrophy, Epispadias and cloacal exstrophy. This case was not a part of exstrophy epispadias complex and it was an isolated continent epispadias which is extremely rare and it was managed with Cantwell Ransley epispadias repair technique.

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16

Mostaque, AK, MS Huq, T. Islam, SM Haque, and MM Rahman. "Primary closure of the Urinary Bladder, Urethra and Anterior Abdomen of Classical and Cloacal 39 Exstrophy - A Preliminary Experience of Three Consecutive Cases." Journal of Surgical Sciences 16, no. 1 (April 5, 2013): 39–43. http://dx.doi.org/10.3329/jss.v16i1.14447.

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A 4 years old female and 1.5 months old male with classical exstrophy and a 2 days old male child with cloacal exstrophy were admitted in Paediatric Surgery Department of Sher-e-Bangla Medical College Hospital (SBMCH), Barisal. The mothers of all children had complaints of protrusion of fleshy mass in lower abdomen from birth. They always remain wet producing smell of urine. The cloacal exstrophy case had a prolapsed ileum that was discharging stool. He had no anus too. All of the cases underwent one stage closure of urinary bladder and urethra and lower abdomen without osteotomy and patient was discharged. After 8 months of first operation the female patient underwent repair of the wound dehiscence. At the time of discharge her urinary bladder capacity was 10 ml and remained dry for 5 minute after manual evacuation. The male patient with classical exstrophy developed urethrocutaneous fistula on 15th post-operative day. The cloacal exstrophy case was discharged with end ileostomy on 10th post-operative day. DOI: http://dx.doi.org/10.3329/jss.v16i1.14447 Journal of Surgical Sciences (2012) Vol. 16 (1) : 39-43

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17

Cekovic, Jelena, and Olivera Laban. "Bladder exstrophy." PONS - medicinski casopis 13, no. 2 (2016): 75–79. http://dx.doi.org/10.5937/pomc13-10922.

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18

Mendes, Gustavo Gomes, and Joel Rodrigo Beal Lusa. "Bladder exstrophy." Revista da Associação Médica Brasileira 62, no. 3 (June 2016): 197–98. http://dx.doi.org/10.1590/1806-9282.62.03.197.

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SUMMARY Bladder exstrophy is a rare congenital anomaly resulting from failure of fusion of the middle of the pelvis line tissues during embryogenesis. It is characterized by malformation of the lower abdominal wall involving the genitourinary tract and the musculoskeletal system. Its incidence is estimated at 1:30,000 to 1:50,000 live births, and it is 2 or 3 times more frequent in males. The child’s age is important and the best results are obtained when treatment is performed shortly after birth.

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19

Uludag, Seyfettin, Onur Guralp, Murat Akbas, Yavuz Aydin, Cihat Sen, and Sezin Uludag. "Bladder Exstrophy." Fetal and Pediatric Pathology 31, no. 4 (March 20, 2012): 225–29. http://dx.doi.org/10.3109/15513815.2011.650286.

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20

Reddy, R. A. "Cloacal exstrophy." Archives of Disease in Childhood 88, no. 4 (April 1, 2003): 277. http://dx.doi.org/10.1136/adc.88.4.277.

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21

Manstein, Carl H. "CLOACAL EXSTROPHY." Plastic and Reconstructive Surgery 110, no. 1 (July 2002): 380. http://dx.doi.org/10.1097/00006534-200207000-00123.

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22

Metcalfe, Peter D., and Robert D. Schwarz. "Bladder Exstrophy." Journal of Wound, Ostomy and Continence Nursing 31, no. 5 (September 2004): 284–92. http://dx.doi.org/10.1097/00152192-200409000-00011.

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23

Mercy, Natalie, and Barbara Brady-Fryer. "Bladder Exstrophy." Journal of Wound, Ostomy and Continence Nursing 31, no. 5 (September 2004): 293–98. http://dx.doi.org/10.1097/00152192-200409000-00012.

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24

Boemers, T. M. L., T. P. V. M. de Jong, P. D. J. Vegt, and R. J. Zeeman. "Duplicate exstrophy." Pediatric Surgery International 10, no. 2-3 (February 1995): 183–85. http://dx.doi.org/10.1007/bf00171193.

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25

Manzoni, Gianantonio M., and Philip G. Ransley. "Bladder exstrophy." Current Opinion in Urology 4, no. 6 (November 1994): 313–15. http://dx.doi.org/10.1097/00042307-199411000-00005.

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26

Ibrahim, Ibrahim Ali, and Sarah Magdy Abdelmohsen. "Caecal exstrophy." Journal of Pediatric Surgery Case Reports 89 (February 2023): 102543. http://dx.doi.org/10.1016/j.epsc.2022.102543.

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27

Mitchell, Michael E. "Bladder exstrophy repair: Complete primary repair of exstrophy." Urology 65, no. 1 (January 2005): 5–8. http://dx.doi.org/10.1016/j.urology.2004.07.030.

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28

Sakellaris, George, Raimondo M. Cervellione, and Alan P. Dickson. "An Unusual Bladder/Cloacal Exstrophy with Urachal Exstrophy." Urologia Internationalis 81, no. 1 (2008): 113–15. http://dx.doi.org/10.1159/000137651.

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29

Kumar, Prashant, Rishi Nayyar, Amlesh Seth, and Deepti Gupta. "Management of cavernous abdominal wall defects post radical cystectomy in adult exstrophy complex." BMJ Case Reports 12, no. 1 (January 2019): bcr—2018–226076. http://dx.doi.org/10.1136/bcr-2018-226076.

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The exstrophy–epispadias complex represents a spectrum of genitourinary malformations ranging from simple glanular epispadias to an overwhelming multisystem defect, cloacal exstrophy. Neonatal total reconstruction of bladder exstrophy–epispadias complex is the treatment of choice. An adult patient presenting with untreated exstrophy is very rare. Malignant transformation, commonly adenocarcinoma, in such cases is a known complication due to mucosal metaplasia of urothelium. Management in such cases necessitates a radical surgical procedure that often results in a massive defect in the anterior abdominal wall. Providing a cover for such defects is a challenging task for the reconstructive surgeon. Local skin flaps and wide mobilisation of the rectus muscle are the usually employed techniques for closure of such defects. However, these may be inadequate in extremely large defects such as those encountered in our patients. We, hereby, describe our technique of closure of the abdominal wall defect using a pedicled anterolateral thigh flap.

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30

Amin, Kinnari Vilaschandra, Namrata Tiwari, Anchal Goel, and Anahita R. Chauhan. "Pregnancy in case of exstrophy of bladder." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 4 (March 30, 2017): 1676. http://dx.doi.org/10.18203/2320-1770.ijrcog20171453.

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Bladder exstrophy or ectopia vesica is an unusual congenital anomaly which exists in the spectrum of the exstrophy- epispadias complex. It most commonly involves protrusion of the urinary bladder due to defect in the lower abdominal wall. It has variable presentation and often includes abnormalities of the pelvic floor, bony pelvis and genitalia. Patients undertaking pregnancy after surgical repair of such an anomaly are rare. Planned Cesarean section at term is considered the appropriate mode of delivery. We present a case of 21-year-old patient who had uneventful preterm vaginal delivery following surgical repair of bladder exstrophy in childhood.

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31

Nikolaev, Vasily V., Nikita V. Demin, and Elizaveta A. Ladygina. "Delayed surgical treatment of children with exstrophy without approximation of the pubic bones, the use of displaced flaps and immobilization of the patient." Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care 11, no. 4 (December 18, 2021): 445–54. http://dx.doi.org/10.17816/psaic1031.

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BACKGROUND: Bladder exstrophy is one of the most difficult for the reconstruction of malformations. AIM: This study aimed to evaluate the outcomes of delayed bladder closure in exstrophy in comparison with procedures in newborns and to test the hypothesis that the reliability of bladder closure does not decrease without closing the fascial defect between the rectus abdominis muscles and that the postoperative period is more favorable. MATERIALS AND METHODS: Delayed closure of exstrophy without osteotomy, convergence of pubic bones, or flap movement was performed in 46 patients with classic bladder exstrophy. Among them, 34 were primary patients, and the remaining patients, who had a complete relapse of exstrophy as a result of suture divergence, had undergone unsuccessful surgery in other clinics 14 times (n = 12). In total, 25 were boys and 21 were girls who underwent surgery from 2006 to 2021. RESULTS: Delayed bladder closure was successful in all 46 children (100%). No signs of acute pain were noted. Serious complications such as dehiscence of the sutures in the bladder and proximal urethra were not observed. Minor complications occurred in five patients, which resolved promptly. DISCUSSION: In the treatment of exstrophy, successful primary bladder closure is critical to achieving future urinary continence. The elimination of the defect between the rectus abdominis muscles with the convergence of the pubic bones has significant drawbacks, including an increase in the operating time and trauma, need for blood transfusion, risk of orthopedic and neurological complications, and a more difficult postoperative period. The vast majority of the patients develop rediastasis. The authors proposed a more reliable method of delayed closure of exstrophy. CONCLUSIONS: The presented method of bladder closure was 100% successful. The procedure was simplified technically, the surgery time was reduced, and the postoperative period proceeded more easily without prolonged pain syndrome, prolonged use of analgesics, and, in most cases, without blood transfusions.

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32

Baradaran, Nima, and John P. Gearhart. "Bladder Exstrophy-Epispadias-Cloacal Exstrophy Complex: A Contemporary Overview." NeoReviews 11, no. 12 (December 2010): e705-e713. http://dx.doi.org/10.1542/neo.11-12-e705.

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33

Sahoo, Sakti Prasad, Ajay Narayan Gangopadhyay, Chandrasen Kumar Sinha, Dinesh Kumar Gupta, and Saroj Chooramani Gopal. "Covered Exstrophy: A Rare Variant of Classical Bladder Exstrophy." Scandinavian Journal of Urology and Nephrology 31, no. 1 (January 1997): 103–6. http://dx.doi.org/10.3109/00365599709070312.

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34

Gupta, Vikas, Nitin Jain, T. C. Sadasukhi, K. K. Sharma, R. G. Yadav, R. Mathur, V. Tomar, S. S. Yadav, and S. Priyadarshi. "Protrusion of bladder mucosa in exstrophy mimicking cloacal exstrophy." Journal of Pediatric Urology 1, no. 2 (April 2005): 105–6. http://dx.doi.org/10.1016/j.jpurol.2004.12.002.

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35

Seat, Mara, Munira Boxwalla, Arielle Hough, and Glenn Goodwin. "A case of congenital cloacal exstrophy/omphalocele-exstrophy-imperforate anus-spinal defects syndrome and a successful pregnancy." Clinical and Experimental Reproductive Medicine 49, no. 3 (September 1, 2022): 215–18. http://dx.doi.org/10.5653/cerm.2021.05148.

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Herein, we report an exceptionally rare case of a 25-year-old woman with cloacal exstrophy/omphalocele-exstrophy-imperforate anus-spinal defects (OEIS) syndrome achieving a viable pregnancy despite many gastrointestinal and genitourinary malformations and multiple respective corrective operations. The patient was born with two vaginas, two uteruses, four ovaries, an imperforate anus, a large omphalocele including bowel and bladder exstrophy, and diaphysis of the pubic rami. This patient is the only documented OEIS patient not to have tethered spinal cord as an anomaly, perhaps contributing to her successful pregnancy. After experiencing preeclampsia with severe features at 35 weeks, the baby was born via cesarean section.

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36

Ansari, Tazeem Fatima, Prachi Gandhi, Poonam Wade, Vinaya Lichade Singh, Kiran Khedkar, and Sushma Malik. "Bladder exstrophy with inguinal hernia: a case report." International Journal of Contemporary Pediatrics 7, no. 5 (April 24, 2020): 1155. http://dx.doi.org/10.18203/2349-3291.ijcp20201656.

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Exstrophy of urinary bladder with epispadias involves protrusion of the urinary bladder through a defect in the lower abdominal wall accompanied by separation of pubic symphysis. It is a rare but challenging condition that causes significant physical, functional, social, sexual and psychological problems later in life. Bladder exstrophy commonly involves males and most cases are sporadic. Inguinal hernia is a complication associated with bladder exstrophy and it occurs due to lack of obliquity of the inguinal canal secondary to pubic diastasis. Authors report here, a case of antenatally diagnosed case of classic bladder exstrophy associated with left sided inguinal hernia which was incidentally diagnosed on tenth day of life. Our neonate underwent primary bladder closure with herniotomy. Staged reconstruction of epispadias and bladder neck has been planned at a later date. Recurrence of inguinal hernia after repair is common and bilateral inguinal exploration while performing herniotomy is advised to prevent its recurrence. Prognosis of such cases depends on the degree of continence achieved. With timely reconstructive surgery, continence rates can be as high as 60-70 percent.

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37

Marvin, Tracy. "Cloacal Exstrophy: A Case Study." Neonatal Network 26, no. 1 (January 2007): 21–30. http://dx.doi.org/10.1891/0730-0832.26.1.21.

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Cloacal exstrophy is a complex congenital anomaly that affects both the gastrointestinal and genitourinary systems. It is characterized by an omphalocele, an exstrophied bladder, abnormal genitalia, and imperforate anus. Prior to 1960, there were no reported cases of survival, but because of advancements in neonatology, surgery, and anesthesiology, the survival rate has improved drastically. This case presentation of an infant born with cloacal exstrophy includes discussion of etiology, diagnosis, treatment, ethical issues, and nursing care.

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38

Novak, Thomas E. "Failed exstrophy closure." Seminars in Pediatric Surgery 20, no. 2 (May 2011): 97–101. http://dx.doi.org/10.1053/j.sempedsurg.2010.12.004.

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39

McLaughlin, Kevin P., Richard C. Rink, John E. Kalsbeck, Michael A. Keating, Mark C. Adams, Shelly J. King, and Thomas G. Luerssen. "Discussion: Cloacal Exstrophy." Journal of Urology 154, no. 2 (August 1995): 785–86. http://dx.doi.org/10.1016/s0022-5347(01)67163-5.

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40

Crankson, S. J., and S. Ahmed. "Female bladder exstrophy." International Urogynecology Journal 8, no. 2 (March 1997): 98–104. http://dx.doi.org/10.1007/bf02764825.

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41

Stuhldreher, Peter P., Brian Inouye, and John P. Gearhart. "Exstrophy-Epispadias Complex." Current Bladder Dysfunction Reports 10, no. 3 (August 9, 2015): 227–32. http://dx.doi.org/10.1007/s11884-015-0306-7.

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42

Zulfiqar, Yevri, Etrivel Myh, Yusrawati Yusrawati, Joserizal Serudji, Irfan Wahyudi, and Arry Rodjani. "Delivery in a Female Bladder Exstrophy Patient With Ileal W Pouch Continent Cutaneous Stoma." Open Access Macedonian Journal of Medical Sciences 10, no. C (February 17, 2022): 119–22. http://dx.doi.org/10.3889/oamjms.2022.8427.

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Propose: To deliver a case report of female bladder exstrophy patients who experienced pregnancy until the birth process. Methods: A 28-year-old woman with a history of bladder exstrophy, which received inadequate treatment during childhood, had bladder shrinkage and uterine prolapse. The patient underwent reconstruction of continent cutaneous stoma and sacrocolpopexy with mesh in her adulthood. She achieved complete continence by intermittent self-catheterization and gained a better quality of life. She later got married and became pregnant. Pregnancy monitoring was done to evaluate the condition of the patient and her fetus. A collaborative team was built to discuss the best option for delivering the procedure. At 38–39 weeks of gestational age, an elective cesarian section was performed to deliver the baby. Results: Despite having a greater risk of complications, a woman with a history of bladder exstrophy could undergo pregnancy and give birth. The choice of delivery, either vaginal or cesarean section, is feasible for delivery. Conclusions: An adult female with bladder exstrophy underwent pregnancy and gave birth. Prior surgery and increased risk of obstetrical complications must be considered.

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Etta, Otu Enenyi, and Monday Ituen. "Perioperative Challenges in Repeat Bladder Exstrophy Repair - Case Report." Open Access Macedonian Journal of Medical Sciences 3, no. 3 (July 26, 2015): 432–35. http://dx.doi.org/10.3889/oamjms.2015.047.

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Bladder exstrophy is a rare congenital malformation. It presents as leakage of urine in the anterior abdominal wall following defects in midline anterior abdominal wall skin and bladder. We report the use of combined general anaesthesia and caudal epidural analgesia in a 4yr old boy for repeat bladder exstrophy repair. Problems of prolonged surgery and the challenges of pain and sedation management in the post operative period are discussed.

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Tu, William, Jane Chueh, and William Kennedy. "Dichorionic Diamniotic Twin Pregnancy Discordant for Bladder Exstrophy." Advances in Urology 2009 (2009): 1–3. http://dx.doi.org/10.1155/2009/186483.

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A 38 year-old woman presented with a dichorionic diamniotic twin pregnancy at gestational age of 32 weeks concerning for an abdominal wall mass in one of the twins. Initial ultrasound evaluation was suspicious for an omphalocele, but the affected twin was found to have bladder exstrophy at birth. This illustrates the difficulties of accurate prenatal diagnosis of bladder exstrophy in a twin pregnancy at a late gestation.

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Manfroi, Cesar, Rafael Miranda Lima, and Edevard José De Araújo. "Female urogenital reconstruction in a case of sexual development disorder (46, XY) with cloacal exstrophy associated with diphallia." VITTALLE - Revista de Ciências da Saúde 34, no. 1 (August 10, 2022): 145–51. http://dx.doi.org/10.14295/vittalle.v34i1.13867.

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Disorders (or differences) of Sex Development (DSD) comprise a state of genetic, gonadal and genital variation. Among the conditions associated with DSD is cloacal exstrophy, a rare congenital malformation part of the exstrophy-epispadias malformation complex. Thus, the case of a patient with rare involvement of DSD 46, XY cloacal exstrophy associated with diphallia who underwent surgical treatment for female urogenital reconstruction is reported. The patient's electronic medical record was reviewed after presenting and accepting the Informed Consent. Sociodemographic and clinical-epidemiological variables and pre- and postoperative data were analyzed. The patient was 20 years old, white and raised considering to be female. She was born with cloacal exstrophy, with severe morphological changes in the external genitalia, and submitted to terminal ileostomy, cystoplasty, and rudimentary large bowel colectomy during the neonatal period. At 13 years of age, the patient reported discomfort with the appearance of her external genitalia and the need for constant use of diapers due to urinary incontinence. The patient underwent reconstruction of the urinary and genital tracts during adolescence besides a genitoplasty followed by regular vaginal dilation. At age 17, she reported feeling satisfied with the surgical result, denied discomfort with the current aspect of her genitalia and mentioned identifying herself with the female and male genders, with increased adherence to typically female behaviors. A supposedly favorable outcome in the late adolescence of a DSD 46, XY cloacal exstrophy subject who underwent surgical adaptation for sexual definition after a multidisciplinary approach was reported. The patient revealed a non-binary gender identity, absence of gender dysphoria, satisfaction with her own body and androphilic sexual orientation.

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Rudin, Yuriy E., Yu Yu Sokolov, A. Yu Rudin, A. S. Kirsanov, N. V. Medvedeva, and E. V. Kartseva. "VOLUME OF SURGERY IN THE PRIMARY CLOSURE OF BLADDER IN CHILDREN WITH BLADDER EXSTROPHY." Russian Journal of Pediatric Surgery 24, no. 1 (March 13, 2020): 21–28. http://dx.doi.org/10.18821/1560-9510-2020-24-1-21-28.

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Introduction. Bladder exstrophy is one of the most complex malformations in pediatric urology. Material and methods. In 1996-2019, 112 children with bladder exstrophy, aged 2 -32 days, had a “primary bladder repair” in St Vladimir Children’s Municipal Clinical Hospital. All children (112) were divided into groups depending on dimensions of the cystic area: large bladder size (over 5 cm) - 39 (34.8%) patients; average size (35-50 mm) - 43 (38.9%); small size (less than 35mm) - 31 children (27.6%). Subgroup “A” - 77 patients (68.7%) were treated in 1996 - 2012, and the primary bladder closure was performed at their neonatal period regardless of the area size. Subgroup “B” - 35 children (31.2%), operated on in 2013-2019, had various volume surgeries depending on clinical manifestations. These groups are homogeneous and comparable in age and manifestations. Results. Complications after surgery were seen in 20 children (25%) from Subgroup “A”: exstrophy relapse - 14 (18%), divergence of bladder neck - 6 (7%). The outcome analysis has shown that the highest rate of exstrophy relapses and cervical divergence was observed in children with microcystis - 15 (57.4%) out of 21. In Subgroup “B”, exstrophy relapse was observed in 1 (2.8%) child with an average bladder size; cervical divergence - in 2 (5.6%) children with an average size and in 2 (5.6%) with microcystis. The number of complications in children with microcystis was reduced from 15 out of 21 children (71%) in Subgroup “A” to 2 out of 10 patients (20%) in Subgroup “B”. Conclusion. A differentiated approach to the choice of surgery volume and proposed additional measures lead to better bladder growth and better urine retention after the first surgery.

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Caione, P., M. De Gennaro, N. Capozza, and S. Nappo. "Orthotopic continent urinary reservoir (Indiana Pouch) in children after cystectomy for bladder exstrophy." Urologia Journal 59, no. 1_suppl (January 1992): 142–45. http://dx.doi.org/10.1177/039156039205901s47.

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In cases of failed exstrophic closure, total cystectomy is sometimes performed combined with external urinary diversion or ureterosigmoidostomy. Prolonged life expectation and the request for a high quality of life, characteristic of pediatric and juvenile age, make it mandatory to look for different surgical solutions. Among 44 patients (26 males and 18 females) born with “exstrophy-epispadias complex”, the creation of a new orthotopic urinary reservoir, according to the “Indiana Pouch” technique, was chosen in 2 children, 4 and 9 years of age respectively, who had previously undergone a total cystectomy elsewhere. The reservoir is made of a ceco-colic segment 35 cm long detubularized on one tenia and remodelled. Ureters are reimplanted with an antireflux technique on the second tenia. Continence is assured by the ileo-cecal valve opportunely reinforced. Both patients are now perfectly continent day and night and voiding is assured by transurethral intermittent catheterization.

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Yarisov, Y. N., V. A. Chernov, L. N. Orlov, and S. V. Berendeev. "Phalloplasty for genitourinary anomalies." Kazan medical journal 80, no. 4 (April 7, 1999): 301–2. http://dx.doi.org/10.17816/kazmj70136.

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Bladder exstrophy is more common in boys and is one of the most severe forms of the anomaly. She is often accompanied by combined anomalies of the reproductive system, pelvic bones, kidneys: epispadias, divergence of the pubic bones, deformity and underdevelopment of the penis, hypoplasia of the testicles, prostate, kidneys. After successful surgical treatment of bladder exstrophy in childhood, with age, there may be a need for rehabilitation surgery for a concomitant anomaly.

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Manzoni, G. A., P. G. Ransley, and Richard S. Hurwitz. "Cloacal Exstrophy and Cloacal Exstrophy Variants: A Proposed System of Classification." Journal of Urology 138, no. 4 Part 2 (October 1987): 1065–68. http://dx.doi.org/10.1016/s0022-5347(17)43503-8.

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Rudin, Yu E., Yu Yu Sokolov, A. Yu Rudin, D. V. Marukhnenko, V. I. Runenko, A. S. Kirsanov, E. V. Kartseva, and N. V. Medvedeva. "Delayed primary bladder’s closure in children with exstrophy, microcystis." Experimental and Сlinical Urology 13, no. 4 (October 30, 2020): 146–54. http://dx.doi.org/10.29188/2222-8543-2020-13-4-146-154.

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Introduction. The small size of the bladder plate is a poor prognostic sign for successful treatment of exstrophy. Primary closure in newborns and infants with microcystisis often accompanied by complications and relapses; there for, the approach to the treatment of this group of patients requires a more detailed analysis. The aim of the study. Identify advantages and disadvantages of delayed primary closure surgery in patients with bladder exstrophy and microcystis. Materials and methods. During the period from 1994 to 2020, 265 children with bladder exstrophy were subjected to surgery, 123 patients were newborns. There were 37 children with microcystis (bladders plate <3 cm). In 30 children, primary closure was performed at the newborn age. Seven patients with microcystis were subjected to everyday manual and mechanical stretching of the bladder and injections of botulinotoxin type A into the bladder plate (2-3 times) for 1-2 years. In 5 children the size of the bladder plate was increased from 3 cm to 6 cm, they were underwenteded delayed primary closure at the age of 1-2 years, supplemented by ureteroneoimplantation, bladder neck reconstruction, with bilateral osteotomy. Results. Complications of primary closure in patients operated on during the neonatal period (30) such as relapse of the exstrophywere observed in 10 patients (33.3%) and partial wound dehiscence in 3 children (10%). In patients with microcystis that underwent delayed primary closure after stretching the bladder, there was no relapse of exstrophy, and growth of the bladder was observed. Conclusions. In our opinion, delayed primary closure of the bladder in children with microcystis after mechanical stretching of the bladder plate in combination with injections of botulinum toxin type A into the detrusor can improve the results of correction of exstrophy.

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