Abstract Book - 26th ESPU Congress, Joint Meeting with ICCS + SPU + AAP/SOU + AAPU + SFU

S26-17

(P)

THE EFFECT OF TIMING OF COMPLETE PRIMARY REPAIR OF BLADDER

EXSTROPHY ON THE NEED FOR INGUINAL HERNIA REPAIR

Joseph G. BORER

, Evalynn VASQUEZ

, Douglas A. CANNING

, John V. KRYGER

, Alexandra BELLOWS

, Tanya

LOGVINENKO

, Dana WEISS

, Travis GROTH

, Bryan SACK

, Aseem SHUKLA

and Michael E. MITCHELL

1) Boston Children's Hospital, Urology, Boston, USA - 2) Children's Hospital of Philadelphia, Urology, Philadelphia, USA -

3) Children's Hospital of Wisconsin, Urology, Milwaukee, USA - 4) Boston Children's Hospital, Urology and Clinical

Research Center, Boston, USA

INTRODUCTION

Patients with bladder exstrophy (BE) have an increased incidence of inguinal hernia. We determined whether inguinal

hernia occurs more frequently in infants who undergo immediate (≤72 hours of life) versus delayed complete primary

repair of bladder exstrophy (CPRE).

MATERIAL AND METHODS

We performed a multi-institutional retrospective chart review on children with BE repaired by CPRE. Data collected

included preoperative characteristics, age at CPRE, operative details and postoperative course including whether or not

inguinal hernia occurred following CPRE. Logistic regression was used to examine the effect of gender and timing of

closure on the need for inguinal hernia repair.

RESULTS

Ninty-eight children with BE from 3 institutions were closed by CPRE with a median follow up of 68 months (0 – 240

months). Forty-nine patients were closed within 72 hours of birth, of which 28 patients (57%) underwent repair of

inguinal hernia within a median time of 2.5 months (0-49.4 months). In comparison, of the 49 patients closed more

than 72 hours after birth, only 17 patients (34%) had inguinal hernias repaired within a median time of 1.15 months (-

9.7-26.6 months). Female gender and delayed repair were shown to be protective factors against inguinal hernia (p <

0.05). Osteotomies were performed in all patients closed beyond 72 hours of life, but in only 7 cases of early closure, 3

of whom developed a hernia.

CONCLUSIONS

Bladder exstrophy patients with delayed CPRE had decreased incidence of inguinal hernias after closure compared to

those that were closed within 72 hours of age.