Classical bladder exstrophy in an adolescent: A case report on management, challenges and outcome.

Autor: Modekwe VI; Department of Surgery, Nnamdi Azikiwe University Awka; Department of Surgery, Paediatric Surgery Unit, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Ekwunife OH; Department of Surgery, Nnamdi Azikiwe University Awka; Department of Surgery, Paediatric Surgery Unit, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Ugwu JO; Department of Surgery, Nnamdi Azikiwe University Awka; Department of Surgery, Paediatric Surgery Unit, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Ugwunne CA; Department of Surgery, Paediatric Surgery Unit, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Ndukwu CU; Department of Surgery, Nnamdi Azikiwe University Awka; Department of Orthopaedics, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Obiegbu HO; Department of Surgery, Nnamdi Azikiwe University Awka; Department of Orthopaedics, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Obidike AB; Department of Anaesthesia, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria.
Jazyk: angličtina
Zdroj: African journal of paediatric surgery : AJPS [Afr J Paediatr Surg] 2023 Jul-Sep; Vol. 20 (3), pp. 233-237.
DOI: 10.4103/ajps.ajps_172_21
Abstrakt: Classical bladder exstrophy is a congenital anomaly whose management and outcome has advanced over years. Management and outcome are better when management starts at the newborn period. This was the management of a neglected bladder exstrophy in a male presenting at 16 years of age. We report our challenges, management and outcome to highlight the rarity of this presentation, and the adaptation to the usual protocol of care. The patient presented at 16 years of age with classic bladder exstrophy. The bladder plate was contracted and had cystitis. The patient had a modification of complete primary repair of exstrophy (CPRE) with bilateral pelvic osteotomy stabilised with a 7-hole plate and 4 screws, then bladder neck reconstruction + bladder augmentation + cross-trigonal neocystoureterostomy in a 12-h procedure. He had surgical site infection, superficial wound breakdown and vesicocutaneous fistula that all healed with dressing and prolonged suprapubic cystostomy drainage. He achieved some degree of urinary continence and ability to void, though he still has stress incontinence and frequency at 6 months of follow-up. He has a micturition interval of 60-120 min, and is expected to improve. Presentation and repair of classic bladder exstrophy in the adolescent is very rare in the literature and therefore no known standard of care. This report adds to the body of knowledge. Again, this experience lends credence to the proponents of CPRE in reducing the number of procedures required to treat exstrophy.
Competing Interests: None
Databáze: MEDLINE
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