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Classical Bladder Exstrophy in an Adolescent: A Case Report on Management, Challenges and Outcome

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 ch...

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Autores principales: Modekwe, Victor Ifeanyichukwu, Ekwunife, Okechukwu Hyginus, Ugwu, Jideofor Okechukwu, Ugwunne, Chuka Abunike, Ndukwu, Chibuzo Uchechukwu, Obiegbu, Henry Obinna, Obidike, Afam Ben
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10450118/
https://www.ncbi.nlm.nih.gov/pubmed/37470562
http://dx.doi.org/10.4103/ajps.ajps_172_21
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author Modekwe, Victor Ifeanyichukwu
Ekwunife, Okechukwu Hyginus
Ugwu, Jideofor Okechukwu
Ugwunne, Chuka Abunike
Ndukwu, Chibuzo Uchechukwu
Obiegbu, Henry Obinna
Obidike, Afam Ben
author_facet Modekwe, Victor Ifeanyichukwu
Ekwunife, Okechukwu Hyginus
Ugwu, Jideofor Okechukwu
Ugwunne, Chuka Abunike
Ndukwu, Chibuzo Uchechukwu
Obiegbu, Henry Obinna
Obidike, Afam Ben
author_sort Modekwe, Victor Ifeanyichukwu
collection PubMed
description 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.
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spelling pubmed-104501182023-08-26 Classical Bladder Exstrophy in an Adolescent: A Case Report on Management, Challenges and Outcome Modekwe, Victor Ifeanyichukwu Ekwunife, Okechukwu Hyginus Ugwu, Jideofor Okechukwu Ugwunne, Chuka Abunike Ndukwu, Chibuzo Uchechukwu Obiegbu, Henry Obinna Obidike, Afam Ben Afr J Paediatr Surg Case Report 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. Wolters Kluwer - Medknow 2023 2023-01-19 /pmc/articles/PMC10450118/ /pubmed/37470562 http://dx.doi.org/10.4103/ajps.ajps_172_21 Text en Copyright: © 2023 African Journal of Paediatric Surgery https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Case Report
Modekwe, Victor Ifeanyichukwu
Ekwunife, Okechukwu Hyginus
Ugwu, Jideofor Okechukwu
Ugwunne, Chuka Abunike
Ndukwu, Chibuzo Uchechukwu
Obiegbu, Henry Obinna
Obidike, Afam Ben
Classical Bladder Exstrophy in an Adolescent: A Case Report on Management, Challenges and Outcome
title Classical Bladder Exstrophy in an Adolescent: A Case Report on Management, Challenges and Outcome
title_full Classical Bladder Exstrophy in an Adolescent: A Case Report on Management, Challenges and Outcome
title_fullStr Classical Bladder Exstrophy in an Adolescent: A Case Report on Management, Challenges and Outcome
title_full_unstemmed Classical Bladder Exstrophy in an Adolescent: A Case Report on Management, Challenges and Outcome
title_short Classical Bladder Exstrophy in an Adolescent: A Case Report on Management, Challenges and Outcome
title_sort classical bladder exstrophy in an adolescent: a case report on management, challenges and outcome
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10450118/
https://www.ncbi.nlm.nih.gov/pubmed/37470562
http://dx.doi.org/10.4103/ajps.ajps_172_21
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