Bilateral Ureteral Reimplantation at Primary Bladder Exstrophy Closure

Braga, Luis H.; Lorenzo, Armando J.; Jrearz, Ricky; Bägli, Darius; Salle, João L. Pippi

doi:10.1016/j.juro.2010.02.032

Cited by 20 publications

(11 citation statements)

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“…The presence of hydronephrosis after CPRE varies between series and from early to late follow‐up. The incidences of hydronephrosis is 9.0% to 69.6% during early follow‐up, and late‐onset hydronephrosis occurs in 21.8% to 33.9% of patients . In the present series, renal function as determined by serial serum creatinine concentration and renal growth observed with ultrasound was preserved during the follow‐up.…”

Section: Discussionmentioning

confidence: 47%

“…The incidences of hydronephrosis is 9.0% to 69.6% during early follow-up, 6,15,16,20 and late-onset hydronephrosis occurs in 21.8% to 33.9% of patients. 15,25 In the present series, renal function as determined by serial serum creatinine concentration and renal growth observed with ultrasound was preserved during the follow-up. Early-onset hydronephrosis occurred in nine patients (60%), with follow-up, hydronephrosis remained in four (26.6%).…”

Section: Discussionmentioning

confidence: 69%

“…[5][6][7]16 Re-implantation is needed in 48 to 66% of cases. 5,15,20,25 The absence of febrile urinary tract infection has been reported only by Hammouda and Kotb. 6 Recently, Braga et al performed BUR in conjugation with CPRE to reduce the possibility of associated reflux.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of VUR after CPRE varies and the reported incidence is 18.1% to 73.9% . Re‐implantation is needed in 48 to 66% of cases . The absence of febrile urinary tract infection has been reported only by Hammouda and Kotb .…”

Section: Discussionmentioning

confidence: 99%

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Modified penile disassembly technique for boys with epispadias and those undergoing complete primary repair of exstrophy: Long‐term outcomes

et al. 2014

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Abbreviations & AcronymsObjectives: To describe our experience performing the modified penile disassembly technique for boys with epispadias and for those undergoing complete primary repair of exstrophy. Methods: Between January 2004 and July 2009, 34 boys underwent the modified penile disassembly technique at our institution. The first group included 15 boys with bladder exstrophy who underwent complete primary repair of exstrophy. The second group comprised 11 boys with penopupic epispadias after previous closure of bladder exstrophy. The third group included 8 boys with isolated complete epispadias. Results: The age range was 3 months to 8 years (median, 9 months). The follow-up time ranged from 36 months to 8 years (mean, 63 months). A conical-shaped glans with the absence of any ischemic changes occurred in 94% of patients. A mild degree of penile dorsal tilt occurred in 11.7% of patients, urethrocutanous fistula in 17.6% and meatal stenosis 5.8%. In cases of complete primary repair of exstrophy, hydronephrosis occurred in 66.6% of patients. Vesicoureteral reflux appeared in 60% of patients; despite suppressive antibiotic therapy, 33.3% are awaiting reimplantation. Continence with volitional voiding with dry intervals of ≥3 h was achieved in 40% of patients. Conclusions:The modified penile disassembly technique can be used in epispadias and complete primary repair of exstrophy with excellent cosmetic results. Preservation of the distal urethral plate along with both hemiglans avoids shortening and prevents occurrence of hypospadias. Complete primary repair of exstrophy is a feasible technique with positive effects on continence with preservation of kidney function.

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Section: Discussionmentioning

confidence: 47%

Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Modified penile disassembly technique for boys with epispadias and those undergoing complete primary repair of exstrophy: Long‐term outcomes

et al. 2014

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“…In order to maintain some of the advantages of CPRE we developed an alternative strategy for the primary closure of bladder exstrophy. Aiming to increase urethral resistance, but without concomitant epispadias repair, we have been performing bladder neck tailoring and concurrent bilateral ureteral reimplantations during the primary closure of exstrophy [1]. In this way, urethral resistance and early bladder cycling can be safely achieved, factors that ultimately may be relevant to improving bladder capacity and possibly urinary continence.…”

mentioning

confidence: 99%