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PubMed1984

[Exstrophy of the bladder and pregnancy].

Two patients with bladder extrophy who had been operated on during infancy (the one by reconstruction of the bladder and the other by Coffey's operation) had delivered by Caesarean section, in the one patient of one child and in the other of two normal children. They formed the basis of this study. Vesical extrophy or ectopia vesicae is a rare malformation (in 1/40 000 to 1/50 000 births). It occurs most often in male children. It can be associated with genital, urological and orthopaedic malformations. The principal complications that can occur in pregnancy are urinary tract infections, prematurity, malpresentations and genital prolapse. As far as the urological side is concerned the complications are of ureteric stones, metabolic troubles, stenosis or obstruction of the uretero-sigmoid anastomosis following Coffey's operation, and ileal prolapse if Bricker's operation had been undertaken. The ways in which the babies should be delivered are discussed, as are the risks of this malformation recurring in children who are born to mothers with vesical extrophy.

Adult↗
PubMed2003

Results of complete penile disassembly for epispadias repair in 42 patients.

PURPOSE: We evaluated the Mitchell complete penile disassembly technique for epispadias repair. MATERIALS AND METHODS: A total of 42 males 1 month to 22 years old presented for repair of epispadias between 1998 and 2002. Cases were divided into 2 groups. Group 1 included 29 cases of complete epispadias as a component of bladder exstrophy, 8 with previous continent urinary diversion. Group 2 included 13 cases of epispadias alone (10 primary and 3 secondary). Of the 29 patients in group 1, 21 underwent complete penile disassembly as part of 1-stage primary closure of bladder exstrophy. RESULTS: Mean followup was 37.5 months (range 6 to 52). Ischemic changes at the glans penis were observed in 5 cases during our initial experience. Ventral orthotopic meatus was observed in all 42 patients, conical glans in 40 (95.2%), straight shaft in 34 (81%) and urethral fistula in 1 (2.4%). There were no cases of dehiscence, meatal stenosis or urethral stricture. Erectile function was preserved in all patients. CONCLUSIONS: Complete penile disassembly is a safe procedure that can provide normalization of the urethra and penis together with satisfactory cosmetic and functional outcome.

Adolescent↗