Exstrophy epispadias complex with adenocarcinoma in adults: a case series and repair technique

The exstrophy-epispadias-complex (EEC) is a rare congenital malformation with spectrum of abdominal-pelvic fusion abnormalities, an incidence 1/46,000 LB. Recurrence 1 in100 & the male-to-female ratio 2.3:1. Patients rarely may present in adulthood due to lack knowledge or financial constraints; it increases risk bladder carcinoma mostly adenocarcinoma squamous carcinoma, chronic inflammation, infection, and metaplasia. It has significant physical, functional, social, sexual, psychological burden. Three patients have been operated on our institute. A 37-year-old male, 19-year-old 23- year-old female patient. operation planned was radical cystectomy ileal conduit expanded local lymphadenectomy all three patients. pelvis abdominal wall defects were repaired differently post-radical 3 using different techniques. first patient went through primary tension closure, second bilateral rectus muscle used as flap reinforced mesh, third patient, we rotation skin flap. All followed for year. developed wound dehiscence by fecal fistula during follow-up succumb sepsis, recovered well postoperative period, unfortunately, recurrence locally multiple metastases, develops necrosis at tip day 5, however, recover after dressing, no seen year regular follow up. As result, mesh recovers better than flap, which closure.