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Surgical management and postoperative outcome of children with bladder exstrophy

Joseph G Borer, MD, FAAP, FACS
Section Editor
Laurence S Baskin, MD, FAAP
Deputy Editor
Melanie S Kim, MD


Bladder exstrophy is a complex congenital anomaly that is treated surgically (picture 1 and figure 1). Surgery is challenging, as bladder exstrophy involves the urinary, reproductive, and musculoskeletal systems, and, in some patents, the intestinal tract. Major goals of reconstruction are preservation of normal kidney function, development of adequate bladder storage and function (ie, urinary continence), and provision of acceptable genital cosmetic appearance and function.

The surgical management and postoperative outcomes of children with bladder exstrophy are discussed here. The clinical manifestations and initial management of infants with bladder exstrophy are discussed separately. (See "Clinical manifestations and initial management of infants with bladder exstrophy".)


The following approaches, or variations of such, are used to manage bladder exstrophy. The first two interventions result in correction of the underlying defect.

Modern staged repair of bladder exstrophy (MSRBE) involves three staged operations and was initially developed in the 1970s [1,2]. Subsequent modifications have been made over the past several years.

Complete primary repair of bladder exstrophy (CPRBE) was introduced in 1989 with the hope that a single operation would achieve the goals of continence and preservation of renal function [3]. However, follow-up studies demonstrate that many children still require multiple procedures following CPRBE [4]. (See 'Choice of surgical approach' below.)

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Literature review current through: Nov 2017. | This topic last updated: Mar 10, 2017.
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