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S26-19
(P)
DELAYED VERSUS EARLY EXSTROPHY CLOSURE - ANALYSIS OF COMPLICATIONS
RATE
Karina FELBERG, Katarzyna BALAZ and Margaret BAKA-OSTROWSKA
The Children's Memorial Health Institute, Pediatric Urology Department, Warsaw, POLAND
PURPOSE
The aim of the study is to analyse the influence of osteotomy and time of primary bladder extrophy closure in regard to
early postoperative comlications.
MATERIAL AND METHODS
We analyzed retrospectively documentation of 46 patients after primary bladder closure operated in our institution
between 2004 and 2014. Patients were randomized in three groups: group A - 12 newborns operated in the first 3 days
of life (without osteotomy), group B - 12 newborns operated between 4th and 28th day of life (with posterior iliac
osteotomy), group C - 22 patients operated after 28th day of life (with posterior iliac osteotomy), median 46 days.
Occurrence of the wound dehiscency, bladder fistula or re-exstrophy of the bladder was analyzed. Results were
statistically evaluated with the chi-square test.
RESULTS
In group A complications were observed in 3 patients (25%): 1 bladder outlet dehiscency and 2 bladder re-exstrophy. In
group B complication rate was 42% - 5 patients with bladder outlet dehiscency. The lowest complication rate was
observed in the group C. There was only 1 patient with bladder outlet dehiscency in this group. None bladder fistula was
observed. The chi-square test shows statistical importance.
CONCLUSIONS
Bladder exstrophy closure with posterior iliac osteotomy diminished the complications rate when done after 28th day of
life.