Pregnancies following a treated ectopia vesicae

Background: Reports of pregnancies in patients with ectopia vesicae (bladder exstrophy) have been reported in the literature. Aim: To report two pregnancies in a woman treated for ectopia vesicae. Setting: Departments of Obstetrics and Gynaecology and Urosurgery; Cornwall Regional Hospital; Montego Bay; Jamaica; West Indies. Case report: A 24 year old woman who had ectopia vesicae was treated with closure of the bladder and with ureterosigmoidostomy as a child. She subsequently had two consecutive advanced pregnancies. In the first pregnancy; a macerated male stillbirth was delivered per vaginam and there was no adverse effect on the genitourinary system. She was successfully delivered of a live baby boy in a subsequent second pregnancy by Caesarean section. Conclusion: This case underscores the benefits of supervising such pregnancies

Transverse ureterotomy in open ureterolithotomy

Open ureterolithotomy is now a seldom performed operation but is still occasionally necessary. We report on the transverse ureterotomy (TU) in this procedure and its effect on reducing morbidity. Results from 100 cases of TU for stone disease since 1976 were compared with those from 50 ureterolithotomies using the standard longitudinal ureterotomy (LU) performed during the same period. The parameters considered were urinary leakage, length of hospital stay and ureteric narrowing as assessed on intravenous urogram at three months. The cases utilizing TU were associated with significantly less urinary leakage, a shorter hospital stay and no ureteric narrowing. Transverse ureterotomy for stone disease significantly reduces the morbidity associated with the operation when utilizing the standard LU. The fear of transecting the ureter may be overcome by good exposure and gentle careful dissection. We suggest that TU be used for open ureterolithotomy