Single stage primary closure of bladder exostrophy vs two stage closure: experience of 18 patients

ABSTRACT

To study the outcome and complications of single primary repair of Bladder Exostrophy and compare it with two stage repair. Descriptive study. The study was carried out at Paediatric Urology Dept, Children Hospital Complex and Institute of Child Health, Multan from 1[st] January 2008 to 30 December 2009. We retrospectively reviewed the records of all patients operated for primary single stage and two stage repair of Bladder Exostrophy. Patients were divided into two groups based on the type of surgery performed. Group I consist of patients with single stage complete repair and group II consist of patients with two stage repair. Data of both groups was entered on a proforma and surgical outcome, complications and urinary continence was noted. There were total 18 patients 13 male, 3 female, Group I [3 male 5 female] and Group II [10 male]. Age ranges from two days to one year in group one with mean age of four months and in group two age ranges from four days to one year with mean age of six months. Average surgery time, bloodloss and anesthesia recovery time was slightly higher in Group I but the complications like wound infection, wound dehience and reoperation rate was also more in Group I as compared to Group II. Long term outcome like VUR, continence interval was similar in both groups. Single stage primary repair offers the advantage to correct the defect in one sitting and psychologically comfortable for the parents but it needs greater experience and complications are higher in male patients. In our current setup single stage complete repair is suitable in female patients but in males two stage repair is more appropriate with satisfactory results: