Castillo-González JM, Navarrete-Salinas E, Castillo Chavira G, Aragón-Tovar AR, Camacho Trejo VF

Language: Spanish
References: 9
Page: 354-358
PDF size: 405.32 Kb.

ABSTRACT

Background: Exstrophy of the bladder is a pathology caused by developmental defect in the cloacal membrane. Described since antiquity, it is a disease with a high degree of family-related recurrence. Surgical intervention in newborns provides good results in bladder function and continence during the neonatal period. Occasionally patients presenting with this pathology reach adulthood without having received the proper medical attention. The case of a female patient whose treatment began in adulthood is presented.
Clinical case: A female patient diagnosed with untreated exstrophy of the bladder at 40 years of age while completing a normal pregnancy ending in cesarean section is presented. Due to the changes in the bladder mucous membrane and taking into account the socioeconomic condition of the patient, simple cystectomy and ileal conduit were proposed. The patient was not a candidatefor continent reservoir procedure.
Conclusions: It is necessary to be familiar with this pathology in which there are still many management challenges as well as a high morbidity.

REFERENCES

1. Ambrose SS, O´Brien DP III. Surgical embryology of the exstrophy-epyspadis Complex. Surg Clin North Am 1974;54(6):1379-90.

2. Dawn MacLellan. Recent Advances in External Genitalia, Pediatric Clin North Am 2006;53(3):449-64.

3. Austin PF, Homsy YL, Gearhart JP, Porter K, Guidi C, Madsen K, Maizels M Prenatal diagnosis of cloacal exstrophy. J Urol 1998;160(3pt 2):1179-81.

4. Hafez AT, El-Sherbiny MT, Shorrab AA, El-Mowafi H et al. Complete Primary Repair in children presenting late, and failed initial closure. J Urol 2006:175(4 pt 2):1549-52.

5. Gearhart J, Baird AD. The Failed complete repair of bladder exstrophy. J Urol 2005;174(4 pt 2):1669-72.

6. Michael Mitchel, et al. Bladder Exstrophy Repair. J Urol 2005;65:781.

7. Borer JG, Gargollo PC, Hendren WH, Diamond DA, Peters CA, Atala A, Grant R, Retik AB Early outcome following complete primary repair of bladder exstrophy in the newborn J Urol. 2005;174(4 pt 2):1674-8; discussion 1678-9.

8. Nelson CP, Dunn RL, Wei JT, Gearhart JP. Surgical repair of bladder exstrophy in the modern era: contemporary practice patterns and the role of hospital case volume J Urol 2005;174(3):1099-102.

9. Ben-Chaim J, Jeffs RD, Reiner WG, Gearhart JP. The Outcome of patients with classic bladder exstrophy in adult life. J Urol 1996;155(4):1251-2.