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PREOPERATIVE CARE OF POLYPOID EXPOSED MUCOSAL TEMPLATE IN
BLADDER EXSTROPHY: THE ROLE OF HIGH-BARRIER PLASTIC WRAPS IN
REDUCING INFLAMMATION AND POLYP SIZE
Nastaran SABETKISH, Shabnam SABETKISH and Abdol-Mohammad KAJBAFZADEH
Children's Hospital Medical Center, Pediatric Urology Research Center, Section of Tissue Engineering and Stem Cells
Therapy, Tehran, IRAN (ISLAMIC REPUBLIC OF)
PURPOSE
Little attention has been dedicated to the preoperative management of bladder polyps in exstrophy patients. When
delayed closure is planned, non-adherent films (plastic wraps) are recommended for covering the exposed mucosa
preoperatively. This study aims to assess the role of high-barrier plastic wraps in reducing polyps' size and number, and
decreasing the inflammation and allergic reactions in exstrophy cases.
MATERIAL AND METHODS
Twelve patients with polypoid exstrophic bladders were randomized into two groups to receive preoperative care with
polyvinylidene chloride (PVDC) traditional wrap A (n=5) or high-barrier wrap B (n=7). The wraps were applied for six
months before surgery. Polyp size and number, and incidence of infection and skin allergy were assessed every 2-
month.The characteristics of the wraps were also evaluated by Fourier transform infrared spectroscopy (FTIS), scanning
electron microscopy, evaporation tests and bacterial culture tests.
RESULTS
Polyps' size and number decreased in patients who applied the high-barrier wrap B after 6 months. Two of five patients
using wrap A suffered skin allergy while no allergic reaction was detected in group B. Better results were obtained in the
entire laboratory evaluations performed on wrap B regarding evaporation tests and microbial culture tests. Wrap B had
higher integrity and smaller pores in scanning electron microscopy.
CONCLUSIONS
Application of an appropriate wrap may result in lower rates of complications preoperatively. Polyps' size and number
and morbidity may significantly decrease by application of a high-barrier wrap. Certain PVDC wraps with more integrity
and less evaporative permeability may be more "exstrophy-friendly".