Cloacal Exstrophy: a complex disease

Cloacal Exstrophy: a complex disease

Autor Macedo Jr, Antonio Google Scholar
Rondon, Atila Google Scholar
Frank, Ricardo Google Scholar
Bacelar, Herick Google Scholar
Leslie, Bruno Google Scholar
Ottoni, Sergio Google Scholar
Garrone, Gilmar Google Scholar
Liguori, Riberto Google Scholar
Ortiz, Valdemar Autor UNIFESP Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Resumo Introduction Cloacal exstrophy is a rare occurrence with an incidence of 1:200,000 to 1:400,000 live births. It represents one of the most challenging reconstructive endeavors faced by pediatric surgeons and urologists. Aside from the genitourinary defects, there are other associated anomalies of the gastrointestinal, musculoskeletal and neurological systems that require a multidisciplinary approach when counseling anxious parents. Material and Methods We present a video of a patient with cloacal exstrophy treated with 21 days of life. Surgery consisted of separation and tubularization of the cecal plate from the exstrophied bladder halves and colostomy construction. The bladder was closed primarily and umbilical scar reconstructed and used for ureteral and cistostomy drainage. A urethral catheter was used to guide bladder neck tubularization. A final epispadic penis was obtained and planned for further repair in a second step. Results The patient had an initial uneventful postoperative course and immediate outcome was excellent. The bladder healed nicely but patient presented with abdominal distension in the 5th day of postoperative setting requiring parenteral nutrition. The distal colon persisted with lower diameter although non obstructive, but causing difficulty for fecal progression. Continuous colostomy dilatation and irrigation were required. Conclusions Approximating the bladder halves in the midline at birth and primary bladder closure is a viable option, intestinal transit may be a issue of concern in the early postoperative follow-up.
Idioma Inglês
Data de publicação 2013-12-01
Publicado em International braz j urol. Sociedade Brasileira de Urologia, v. 39, n. 6, p. 897-898, 2013.
ISSN 1677-5538 (Sherpa/Romeo)
Publicador Sociedade Brasileira de Urologia
Extensão 897-898
Fonte http://dx.doi.org/10.1590/S1677-5538.IBJU.2013.06.19
Direito de acesso Acesso aberto Open Access
Tipo Artigo
SciELO S1677-55382013000600897 (estatísticas na SciELO)
Endereço permanente http://repositorio.unifesp.br/handle/11600/8065

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