Modern staged reconstruction of bladder exstrophy—still the gold standard

Complications of treatment of obstetric fistula in the developing world: Gynatresia, urinary incontinence, and urinary diversion

“…Over the past 30 years, techniques for the staged reconstruction of the exstrophy–epispadias complex have greatly increased the number of children who develop reasonable urinary continence and can carry on their lives [15]. This progress required the establishment of a disease‐specific model and a treatment paradigm specifically tailored to the patients.…”

Impact of epispadias repair on bladder growth in boys with classic bladder exstrophy

“…Epispadias repair is performed at birth in patients being managed with the Mitchell repair [7] as well as in the complete reconstruction described by Schrott et al [8]. The Modern Staged Reconstruction recommends performance of epispadias repair between 4 and 12 months of age [9]. Patients with adequate bladder capacity for initial closure have epispadias repair performed at 6e12 months of age.…”

Bladder exstrophy and male fertility: pregnancies after ICSI with ejaculated or epididymal sperm

“…The MSA technique results in infertility problems as already described. However, the quality of life is improved owing to the fact that some boys can urinate normally (2). In the older patients with a urinary diversion, there is an increased risk of urinary upper tract deterioration, as observed in patients with a Bricker urinary diversion (11).…”

“…In the last decade, different surgical techniques have been developed, each with its own approach and motivation: the complete primary repair of bladder exstrophy (CPRE) (1) and the modern staged approach (MSA) (2). The CPRE is performed within the first few days after birth and is based on the closure of the bladder and abdominal wall, bladder neck reconstruction, and placing the urethral meatus in the best possible position, together with a penile reconstruction.…”