Francesco Ferrara1, Alan P Dickson2, Janet Fishwick3, Rita Vashisht4, Tahair Khan5, Raimondo M Cervellione6. 1. Department of Paediatric Urology, Royal Manchester Children's Hospital, Oxford Road, Manchester M13 9WL, UK. Electronic address: fferraradoc@gmail.com. 2. Department of Paediatric Urology, Royal Manchester Children's Hospital, Oxford Road, Manchester M13 9WL, UK. Electronic address: alan.dickson@cmft.nhs.uk. 3. Department of Paediatric Urology, Royal Manchester Children's Hospital, Oxford Road, Manchester M13 9WL, UK. Electronic address: janet.fishwick@cmft.nhs.uk. 4. Department of Paediatric Anaesthesia, Royal Manchester Children's Hospital, Manchester, UK. Electronic address: rita.vashisht@cmft.nhs.uk. 5. Department of Paediatric Orthopaedic, Royal Manchester Children's Hospital, Manchester, UK. Electronic address: tahir.khan@cmft.nhs.uk. 6. Department of Paediatric Urology, Royal Manchester Children's Hospital, Oxford Road, Manchester M13 9WL, UK. Electronic address: raimondo.cervellione@cmft.nhs.uk.
Abstract
OBJECTIVE: Delayed exstrophy repair (DER) represents an alternative to early neonatal bladder closure. This study aims to define the consequence of DER on bladder growth in bladder exstrophy patients who underwent routine DER, compared with those who underwent immediate postnatal reconstruction. METHODS: Between 2000 and 2005, classic bladder exstrophy patients referred to the authors' institution underwent early neonatal bladder closure (group 1). Subsequently, classic bladder exstrophy patients referred to the authors' institution were treated with an elective DER (group 2). Bladder capacity was assessed between the age of 1 and 4 years with an unconscious cystogram. When dilating VUR was present, the volume of the contrast migrated into the ureter was calculated and subtracted. RESULTS: Sixty patients were treated between 2000 and 2012. Complete follow-up data were available for 45 patients and they were included in the study: 21 in group 1 (11 males) and 24 in group 2 (14 males). The mean (SD) bladder volumes were 72.85 (28.5) ml in group 1 and 72.87 (34.9) in group 2 (p = 0.99). CONCLUSION: In the authors' experience, DER does not reduce the subsequent bladder capacities compared with neonatal exstrophy closure.
OBJECTIVE: Delayed exstrophy repair (DER) represents an alternative to early neonatal bladder closure. This study aims to define the consequence of DER on bladder growth in bladder exstrophypatients who underwent routine DER, compared with those who underwent immediate postnatal reconstruction. METHODS: Between 2000 and 2005, classic bladder exstrophypatients referred to the authors' institution underwent early neonatal bladder closure (group 1). Subsequently, classic bladder exstrophypatients referred to the authors' institution were treated with an elective DER (group 2). Bladder capacity was assessed between the age of 1 and 4 years with an unconscious cystogram. When dilating VUR was present, the volume of the contrast migrated into the ureter was calculated and subtracted. RESULTS: Sixty patients were treated between 2000 and 2012. Complete follow-up data were available for 45 patients and they were included in the study: 21 in group 1 (11 males) and 24 in group 2 (14 males). The mean (SD) bladder volumes were 72.85 (28.5) ml in group 1 and 72.87 (34.9) in group 2 (p = 0.99). CONCLUSION: In the authors' experience, DER does not reduce the subsequent bladder capacities compared with neonatal exstrophy closure.
Authors: Jennifer Hinley; Rosalind Duke; Jessica Jinks; Jens Stahlschmidt; David Keene; Raimondo M Cervellione; Imran Mushtaq; Paolo De Coppi; Massimo Garriboli; Jennifer Southgate Journal: Am J Pathol Date: 2022-03-28 Impact factor: 5.770