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[The value of posterior iliac osteotomy in the treatment of ectopia vesicae. Two-cases (author's transl)].

The authors emphasise the value of bilateral posterior iliac oestotomy in facilitating aponeurotic and cutaneous closure of ectopia vesicae. The osteotomy cuts the wing of the iliac bone above the greater sciatic notch 2 cms lateral to the sacroiliac joint. The new point made by the author is the use of an external fixation device the pins of which are implanted only in the iliac crest in the still young child, whilst in the adolescent a more solid method of fixation involves in insertion of additional pins in the pubis (taking care to avoid the femoral vessels). The recommended operative schedule is as follows: 1) Simple posterior iliac osteotomy. 2) Bed rest for 8 to 15 days until cutaneous healing of the iliac incisions. 3) Urological phase (which for the author consists of excision of the plaque with ureterocolic implantation) with aponeurotic closure (using eliptical strips fashioned from the rectus sheath) and simple cutaneous closure without any traction because of the osteotomies. 4) Insertion of external fixation device at the end of the urological phase. This is supported by 2 cases reports with and uncomplicated postoperative course from both a urological and orthopaedic standpoint.

Abnormalities, Multiple↗
PubMed1979

[Late results of ureterosigmoidostomy in treating extrophy of the bladder (author's transl)].

26 children with extrophy of the bladder were treated surgically during a period of 23 years. In all cases a ureterosigmoidostomy was performed with a follow up of 1-22 years in 15 of 26 cases. In 9 children the clinical, radiological, and biochemical findings were good in 4 satisfying and 2 bad due to hydronephrosis and electrolyte disturbances. The authors recommend direct implantation of the ureters into the rectosigmoid, according to the technique of Goodwin. This approach is simple from a technical point of view and the immediate and late complications are less frequent than with other methods.

Bladder Exstrophy↗