Staged closure of the pelvis in cloacal exstrophy: first description of a new approach

J Urol. 1999 Jan;161(1):263-6.

Abstract

Purpose: We describe a staged approach for pelvic closure in patients with cloacal exstrophy, and evaluate the technique for functional and cosmetic results.

Materials and methods: Staged closure of the pelvis was performed in 5 patients 12 months to 14 years old with cloacal exstrophy at our institution, including some referred with a history of failed closure. The technique involves initial pelvic osteotomy followed by soft tissue and pelvic ring closure 2 to 3 weeks later. Clinical information is reviewed to assess the effectiveness of the technique.

Results: At a mean followup of 3.2 years (range 1 to 9) closure was successful in all 5 patients without technical problems or surgical complications, and with excellent functional and cosmetic results.

Conclusions: This technique of staged pelvic closure may provide reliable initial or secondary repair in patients with cloacal exstrophy in whom 1-stage pelvic closure is unfeasible even with pelvic osteotomy.

MeSH terms

  • Adolescent
  • Bladder Exstrophy / surgery*
  • Cloaca / abnormalities*
  • Cloaca / surgery*
  • Female
  • Humans
  • Infant
  • Urologic Surgical Procedures / methods*