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CONGRESS OF THE ESPU
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S7-10 (PP)
URETERIC-URETHRAL ENGRAFTMENT
AS A NEW SURGICAL TECHNIQUE FOR MANAGEMENT
OF INCONTINENCE IN BLADDER EXSTROPHY COMPLEX
Shabnam SABETKISH
1
, Nastaran SABETKISH
1
and Abdol-Mohammad KAJBAFZADEH
2
1) Tehran University of Medical Sciences, Pediatric Urology and Regenerative Medicine Research Center, Pediatric
Center of Excellence, Tehran, ISLAMIC REPUBLIC OF IRAN - 2) Tehran University of Medical Sciences, Pediatric
Urology and Regenerative Medicine Research Center, Pediatric Center of Excellence, Tehran, ISLAMIC REPUBLIC
OF IRAN
PURPOSE
To report the results of a novel surgical technique for increasing the continence rate in girls with
intact bladder exstrophy complex (BEC) by ureteric-urethral engraftment (UUE) technique.
MATERIAL AND METHODS
Sixteen girls with a mean ± SD age of 3.4 ± 1.7 years with BEC were referred for further management
from 2009 to 2012. Nine patients out of 16 underwent operation by single staged bladder closure
(group I); while 7 patients underwent the novel technique of UUE for better continence achievement
(group II). Pubic bone adaptation with miniature plate fixation was performed without any type of
osteotomy or leg traction in all the patients. Continence and upper urinary tract evaluation were
performed in the follow-ups with 3 months intervals for the first year and biannually thereafter.
RESULTS
All patients in both groups experienced an uneventful postoperative period. Social continence was
achieved in 5 patients in each group (55.55% and 71.4% respectively). Three (33.3%) and 2 (28.5%)
children were partially continent in group I and II, respectively. One patient was incontinent in group
I, while no child undergoing UEE operation remained incontinent However, 3 patients in UUE group
had postoperative vesicoureteral reflux and hydronephrosis that was successfully managed by
Deflux injection.
CONCLUSIONS
The eventual clinical outcomes of BEC children undergoing the UUE technique were promising.
This practicable, safe, and reproducible option will add one complementary stage to the previously
used reconstruction techniques. These patients will necessitate further surveillance with upper
urinary tract evaluations during the adult life.
11:29–11:44
Discussion