Successful pregnancy in a patient with previous ectopia vesicae.
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From 1987 to 1991, 46 patients underwent surgical treatment for epispadias. Of these, 14 had isolated epispadias and 22 had epispadias within the exstrophy/epispadias complex. The patients ranged in age from 6 months to 20 years. To correct the genital aspect of the anomaly the basic principles of Ransley's technique were used. In addition, the island flap technique was used for the most severe, so-called "cripple" form. In patients with exstrophy/epispadias complex, only elongation of the penis was performed during primary reconstruction, while the correction of epispadias, using the above techniques, was performed in the second-stage operation. Complications occurred in 6 patients.
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Two patients with bladder extrophy are presented. Both had had corrective surgery in childhood and subsequently presented with recurrent procidentia after a previously unsatisfactory repair operation. Both were treated by hysteroscaropexy (a new procedure) which is described in detail and when reviewed 12 months later were symptom-free with good genital tract support.
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