W H Rösch1, M Promm2. 1. Klinik für Kinderurologie in Kooperation mit der Universität Regensburg, Klinik St. Hedwig Regensburg, Steinmetzstr. 1-3, 93049, Regensburg, Deutschland. wolfgang.roesch@barmherzige-regensburg.de. 2. Klinik für Kinderurologie in Kooperation mit der Universität Regensburg, Klinik St. Hedwig Regensburg, Steinmetzstr. 1-3, 93049, Regensburg, Deutschland.
Abstract
BACKGROUND: It is universally agreed that successful and gentle initial bladder closure is decisive for favorable long-term outcome. Due to a number of reasons, including a lack of comparable multicenter studies, there are numerous concepts for initial exstrophy closure. DISCUSSION: Therefore, we describe our concept of delayed, staged reconstruction without osteotomy in classical bladder exstrophy, while taking into considerion the available literature on long-term follow-up as well as on own clinical and research data. CONCLUSION: Most notably there are multiple medical but also psychological advantages of a delayed procedure. Primary closure without osteotomy is feasible and has no disadvantages in the long-term follow-up when compared to the invasive procedure of osteotomy. Due to high intravesical pressure, initial bladder neck surgery might have negative effects on bladder development and on the upper urinary tract.
BACKGROUND: It is universally agreed that successful and gentle initial bladder closure is decisive for favorable long-term outcome. Due to a number of reasons, including a lack of comparable multicenter studies, there are numerous concepts for initial exstrophy closure. DISCUSSION: Therefore, we describe our concept of delayed, staged reconstruction without osteotomy in classical bladder exstrophy, while taking into considerion the available literature on long-term follow-up as well as on own clinical and research data. CONCLUSION: Most notably there are multiple medical but also psychological advantages of a delayed procedure. Primary closure without osteotomy is feasible and has no disadvantages in the long-term follow-up when compared to the invasive procedure of osteotomy. Due to high intravesical pressure, initial bladder neck surgery might have negative effects on bladder development and on the upper urinary tract.
Keywords:
Bladder neck surgery; Initial closure; Long term results; Osteotomy; Urinary tract
Authors: Jessica C Hankinson; Marlo A Eldridge; Rick Ostrander; Bhavik Shah; Elizabeth K Reynolds; Carisa Perry-Parrish; Matt W Specht; John P Gearhart Journal: J Pediatr Urol Date: 2013-08-17 Impact factor: 1.830
Authors: Peter C Rubenwolf; Fabian Eder; Anne-Karoline Ebert; Ferdinand Hofstaedter; Christopher R J Woodhouse; Wolfgang H Roesch Journal: J Urol Date: 2012-10-08 Impact factor: 7.450
Authors: Sanjay M Bhananker; Chandra Ramamoorthy; Jeremy M Geiduschek; Karen L Posner; Karen B Domino; Charles M Haberkern; John S Campos; Jeffrey P Morray Journal: Anesth Analg Date: 2007-08 Impact factor: 5.108
Authors: Michael Amir Kertai; Wolfgang H Rösch; Roland Brandl; Horst Hirschfelder; Nadine Zwink; Anne Karoline Ebert Journal: Eur J Pediatr Surg Date: 2015-10-07 Impact factor: 2.191