Staged Management of Bladder Exstrophy

Bladder exstrophy or as an erroneously known as ectopia vesica is a rare congenital malformation of the lower part of the abdomen and the genital area. It involves the urinary bladder, abdominal wall, pubic bones and the external genitalia. It requires functional reconstruction, which is often done as a single or in multiple stages; the aim of management is to preserve kidney functions, maintain urinary continence, achieve sexual function and near normal appearance of the external genitalia. At King Abdulaziz University Hospital in Jeddah, Saudi Arabia, twelve cases of bladder exstrophy (the classical type) were seen and managed between October 1990 and December 2007. All cases were managed in multiple stages. In this paper reviewed the experience and the results obtained in the management of bladder exstrophy. Out of the twelve cases, four patients achieved urinary continence and seven were incontinent (dry period less than three hours) and one late death. Other complications were also seen and will be discussed during this report.