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https://www.readbyqxmd.com/read/29447946/bladder-re-augmentation-in-classic-bladder-exstrophy-risk-factors-and-prevention
#1
Karl Benz, John Jayman, Karen Doersch, Mahir Maruf, Timothy Baumgartner, Matthew Kasprenski, John P Gearhart
OBJECTIVE: To characterize the causes of re-augmentation in patients with classic bladder exstrophy. METHODS: A prospectively-maintained institutional database of 1327 exstrophy-epispadias complex patients was reviewed for CBE patients who have undergone more than one AC procedure. Data regarding bladder capacities, complications following AC, and reasons for re-augmentation were evaluated. RESULTS: A total of 166 CBE patients underwent AC...
February 12, 2018: Urology
https://www.readbyqxmd.com/read/29426576/primary-female-epispadias-perineal-approach-or-kelly-repair
#2
Marc-David Leclair, Sébastien Faraj, Thierry Villemagne, Julie Carrouget, Alexis Arnaud, Yves Heloury
OBJECTIVES: Primary female epispadias encompasses a spectrum of disease, presenting with a variable degree of incontinence. We hypothesized that although perineal urethrocervicoplasty can be a successful first-line procedure in patients with normal bladder, a more radical reconstruction was necessary to achieve continence in cases lying at the most severe end of the spectrum. Our aim was to assess the results of a surgical management using perineal approach in girls with normal bladder capacity, and Kelly radical soft-tissue mobilization (RSTM) in patients with inadequate bladder, based on the assumption that bladder capacity (BC) is a reliable marker of epispadias severity...
October 9, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29370895/pelvic-and-lower-extremity-immobilization-for-cloacal-exstrophy-bladder-and-abdominal-closure-in-neonates-and-older-children
#3
Karl S Benz, John Jayman, Mahir Maruf, Timothy Baumgartner, Matthew C Kasprenski, Daniel A Friedlander, Heather N Di Carlo, Paul D Sponseller, John P Gearhart
INTRODUCTION: Successful bladder closure in cloacal exstrophy (CE) is best accomplished through a multidisciplinary team and attention to pre- and postoperative technique. This study from a high volume exstrophy center investigates outcomes and complications of primary and reoperative bladder closures in patients immobilized with spica cast or patients with external fixation (EF) and skin traction. METHODS: The authors reviewed an institutionally approved and daily updated database of 1311 patients with exstrophy-epispadias complex and identified patients with cloacal exstrophy born between 1975 and 2015 who had undergone primary or reoperative bladder closures...
December 27, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29368874/preoperative-care-of-polypoid-exposed-mucosal-template-in-bladder-exstrophy-the-role-of-high-barrier-plastic-wraps-in-reducing-inflammation-and-polyp-size
#4
Nastaran Sabetkish, Shabnam Sabetkish, Abdol-Mohammad Kajbafzadeh
OBJECTIVE: To assess the role of high-barrier plastic wrap in reducing the number and size of polyps, as well as decreasing the inflammation and allergic reactions in exstrophy cases, and to compare the results with the application of low-barrier wrap. MATERIALS AND METHODS: Eight patients with bladder exstrophy-epispadias complex (BEEC) that had used a low density polyethylene (LDPE) wrap for coverage of the exposed polypoid bladder in preoperative care management were referred...
January 26, 2018: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/29318419/prolapsed-bladder-following-rupture-of-patent-urachal-cyst-mimicking-bladder-exstrophy-a-case-report-and-literature-review
#5
Kasemsri Srisupundit, Phitsanu Mahawong, Cholaros Charoenratana, Theera Tongsong
A 26-year-old pregnant woman was diagnosed with fetal bladder prolapse following rupture of a patent urachus/urachal cyst, based on the finding of cyst disappearance with replacement with an infra-umbilical, extra-abdominal solid soft-tissue mass, mimicking bladder exstrophy. The neonatal findings confirmed the prenatal diagnosis. The baby was healthy and had a successful surgical correction. This report provides clues to differentiating ruptured bladder prolapse from bladder exstrophy as follows: (1) well-documented urachal cyst with urine-filled mass in the early gestation, (2) development of solid soft-tissue mass shortly after disappearance of the urachal cyst, and (3) no other structural abnormalities (bladder exstrophy is usually associated with abnormal genitalia, epispadias, or pubic diastasis)...
January 9, 2018: Journal of Medical Ultrasonics
https://www.readbyqxmd.com/read/29150195/anatomic-findings-associated-with-epispadias-in-boys-implications-for-surgical-management-and-urinary-continence
#6
M Cendron, P S Cho, M Pennison, I Rosoklija, D A Diamond, J G Borer
INTRODUCTION: Pre-operative physical examination of male epispadias allows for classification of epispadias level as glanular (GE), penile (PE) or penopubic (PPE), and for delineation of anatomic anomalies. The incidence of associated extragenital abnormalities, such as vesicoureteral reflux (VUR), bladder neck (BN) abnormality and abnormal pubic diastasis (PD), and their impact on urinary continence has not yet been systematically studied. OBJECTIVE: The goal of this study was to evaluate whether the more proximal level of epispadias correlated with associated extragenital anatomic anomalies seen on initial imaging or endoscopic evaluation, and whether these pre-operative findings contributed to subsequent surgical management and impacted on achieving urinary continence...
October 26, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29126846/sexual-function-and-quality-of-life-in-adult-male-individuals-with-exstrophy-epispadias-complex-a-survey-of-the-german-cure-network
#7
J Traceviciute, N Zwink, E Jenetzky, H Reutter, K Hirsch, R Stein, W H Rösch, A K Ebert
OBJECTIVE: To investigate sexual function and quality of life (QoL) in adult male individuals with exstrophy-epispadias complex (EEC). Data from the German network for congenital uro-rectal malformations (CURE-Net) were used. PATIENTS AND METHODS: 51 males (≥18 years) recruited by CURE-Net between 2009 and 2012 were re-contacted per mail and asked to fill out four questionnaires including International Index of Erectile Function (IIEF-5), Cologne assessment of Erectile Dysfunction (KEED), the Short-Form 36 (SF-36) and one self-designed questionnaire about their medical history, current health status, sexual experience...
November 7, 2017: Urology
https://www.readbyqxmd.com/read/29126155/isl1-mediates-mesenchymal-expansion-in-the-developing-external-genitalia-via-regulation-of-bmp4-fgf10-and-wnt5a
#8
Saunders T Ching, Carlos R Infante, Wen Du, Amnon Sharir, Sungdae Park, Douglas B Menke, Ophir D Klein
Genital malformations are among the most common human birth defects, and both genetic and environmental factors can contribute to these malformations. Development of the external genitalia in mammals relies on complex signaling networks, and disruption of these signaling pathways can lead to genital defects. Islet-1 (ISL1), a member of the LIM/Homeobox family of transcription factors, has been identified as a major susceptibility gene for classic bladder exstrophy in humans, a common form of the bladder exstrophy-epispadias complex (BEEC), and is implicated in a role in urinary tract development...
November 8, 2017: Human Molecular Genetics
https://www.readbyqxmd.com/read/28988809/commentary-on-primary-female-epispadias-perineal-approach-or-kelly-repair
#9
Ranjiv I Mathews
No abstract text is available yet for this article.
September 19, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28986224/autophagy-apoptosis-and-cell-proliferation-in-exstrophy-epispadias-complex
#10
Mahsa Shabaninia, Ali Tourchi, Heather Di Carlo, John Gearhart
OBJECTIVE: To investigate the state of autophagy and its interactions with apoptosis and cell proliferation in patients who underwent successful early closure or delayed closure of exstrophy. They compared those outcomes with cell culture samples from patients with VUR as control. METHODS: Primary cultures of bladder smooth muscle cells were established from patients with successful neonatal bladder closure (group 1, N=5), delayed closure due to small bladder template (group 2, N=5) and vesicoureteral reflux as control (group3, N=5)...
October 3, 2017: Urology
https://www.readbyqxmd.com/read/28958802/cystectomy-in-the-pediatric-exstrophy-population-indications-and-outcomes
#11
Joan Ko, Kathy Lue, Daniel Friedlander, Timothy Baumgartner, Peter Stuhldreher, Heather N DiCarlo, John P Gearhart
OBJECTIVE: To explore the long-term outcomes and indications for cystectomy in bladder exstrophy patients. Although rare, cystectomy is the final surgical alternative to bladder repair among these patients with a poor quality bladder template. METHODS: A prospectively maintained database of 1298 patients with exstrophy-epispadias complex was reviewed for patients who underwent cystectomy between 1970 and 2015 at the author's institution. Demographic data, indication for cystectomy, surgical history, post-operative outcomes, and continence status were collected...
September 25, 2017: Urology
https://www.readbyqxmd.com/read/28924534/image-of-the-month-clinical-features-in-a-newborn-with-covered-cloacal-exstrophy
#12
Alejandra Vilanova-Sánchez, Christina B Ching, Alessandra C Gasior, Karen Diefenbach, Richard J Wood, Marc Levitt
Cloacal exstrophy is the most severe type of anorectal malformations that belongs to the bladder-exstrophy-epispadias complex of genitourinary malformations. Interestingly, its variant, the covered cloacal exstrophy, is often missed. The clinical findings of this variant may include an imperforate anus, low lying umbilicus, thick pubic bone, and pubic diastasis but with an intact abdominal wall. We present an interesting case of covered cloacal exstrophy with a side-by-side duplicated bladder and discuss important considerations for the time of colostomy creation in the newborn period...
January 2017: European Journal of Pediatric Surgery Reports
https://www.readbyqxmd.com/read/28892921/a-rare-case-of-genital-malformation-with-omphalocele-exstrophy-of-bladder-imperforate-anus-and-spinal-defect-complex-autopsy-findings
#13
K Mamatha, B R Yelikar, Varsha R Deshpande, B S Disha
Omphalocele, Exstrophy of cloaca, Imperforate anus and Spinal defects (OEIS) is a severe manifestation of exstrophy-epispadias sequence with a combination of defects including OEIS. It results from improper closure of anterior abdominal wall and defective development of cloaca and urogenital septum due to defect in blastogenesis during the 4(th) week of gestation. Identification of this complex is important through foetal autopsy as this condition can recur in siblings. Prenatal diagnosis also helps to prevent foetal death with appropriate management in the less severe cases...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28888749/complete-penile-disassembly-for-repair-of-epispadias-causes-erectile-tissue-alteration-through-tgf-%C3%AE-1-overexpression-in-rabbit-model
#14
Ali Tourchi, Mahsa Shabaninia, Meghan Stewart, Hiroshi Miyamoto, Heather Di Carlo, John Gearhart
OBJECTIVE: To investigate corporal tissue viability and changes in endothelial content following current techniques used for epispadias repair in animal model MATERIALS AND METHODS: Sixty rabbits were allocated into three groups: Sham operation (penile degloving), complete disassembly model, and Cantwell-Ransley model. On weeks 2, 4, 12, and 24 post-op, the penile tissue was harvested and processed for (i)Masson's trichrome staining for smooth muscle cell(SMC)/collagen ratios (ii)immunohistochemical staining for endothelial factor(CD31) and TGF-β1 (iii)TUNEL assay to detect apoptosis...
September 6, 2017: Urology
https://www.readbyqxmd.com/read/28861290/mystery-and-realities-of-phalloplasty-a-systematic-review
#15
REVIEW
Selçuk Sarıkaya, David John Ralph
The neophallus creation is still a mystery and it remains challenging even today. In this article, we performed a comprehensive review of the literature regarding phalloplasty and penile reconstructive surgery between January 2008 and May 2016. In this review, we have included 15 research articles and the results of 276 patients were examined. Studies revealed several indications and when indications were reviewed, 191 patients were female-to-male transgender, 9 patients had disorder of sex development/micropenis, 16 had penile amputation/trauma, 9 had ambiguus genitalia, 40 had exstrophy and/or epispadias, 11 had other problems...
September 2017: Turkish Journal of Urology
https://www.readbyqxmd.com/read/28721463/exstrophy-bladder-reconstruction-or-diversion-for-the-underprivileged
#16
REVIEW
Yogesh Kumar Sarin, Virender Sekhon
The surgical techniques for management of bladder exstrophy epispadias complex have evolved from staged reconstruction, complete primary repair to radical mobilization. Post-operative complications add to the multiplicity of surgical procedures at each step. The end results are variable with many achieving continence rates of 85-89% only after bladder augmentation and clean intermittent catheterization. The situation is further complicated in resource-poor settings, where illiteracy and poverty are the driving factors for choosing a single operative procedure for creation of low pressure reservoir aiming at upper tract preservation and good primary continence...
September 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28712888/is-concealed-epispadias-a-rare-variant
#17
Ahmed Shahat, Ahmed S Safwat, Ahmad Elderwy, Islam F Abdelkawi, Ahmad Elbadry I Abonnoor, Mohamed F Abdelhafez, Ahmed Moeen, Hisham Hammouda
OBJECTIVE: To present our experience with concealed epispadias and to estimate its actual share in the isolated male epispadias cases and its effect on the surgical outcome. MATERIALS AND METHODS: Consecutive patients with isolated male epispadias treated in our center between 2008 and 2015 were classified into concealed and classic epispadias. The 2 groups were compared regarding age at presentation, meatal location, incontinence, dorsal curvature, success rate, and complications...
November 2017: Urology
https://www.readbyqxmd.com/read/28689649/epispadias-repair-with-tunica-vaginalis-flap
#18
R S Zee, J H Makari, Fernando Ferrer, C D A Herndon
INTRODUCTION: Primary epispadias is a rare congenital malformation that afflicts about 1 in 80,000 children. The surgical repair, originally described by Cantwell over 100 years ago, is fundamentally sound and incorporates several important steps to achieve an optimal result. METHODS: A 9-month-old male with penopubic epispadias presented for surgical repair. Pre-operative imaging included a normal renal ultrasound and voiding cystourethrogram that demonstrated a moderate-sized bladder, partially competent bladder neck, and no vesicoureteral reflux...
October 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28652161/the-surgical-management-of-bladder-polyps-in-the-setting-of-exstrophy-epispadias-complex
#19
John Jayman, Ali Tourchi, Mahsa Shabaninia, Mahir Maruf, Heather DiCarlo, John P Gearhart
OBJECTIVE: To investigate the surgical course for treating bladder polyps in patients with exstrophy epispadias complex (EEC). EEC bladder polyps are unique pathologic entities, with a distinct difference between polyps discovered at birth and polyps developed after failed exstrophy closure. METHODS: A prospectively maintained database of 1300 patients with EEC was reviewed for bladder exstrophy patients with bladder polyps. The following data were obtained: patient demographics, polyp type, past medical and surgical history, and continence outcomes...
November 2017: Urology
https://www.readbyqxmd.com/read/28615813/modified-cantwell-ransley-repair-for-isolated-continent-epispadias-in-adult-our-experience
#20
Venkat Arjunrao Gite, Hitesh Mahendra Jain, Sachin M Bote, Jayant Vijay Nikose
PURPOSE: We evaluate here our experience with modified Cantwell-Ransley technique described by Gearhart for correction of isolated continent epispadias in adults with respect to its long-term functional outcome and complications. INTRODUCTION: Isolated male epispadias is a rare anomaly with a reported incidence of 1 in 11,700 males. Many surgical techniques with various modifications described to correct epispadias as treatment are debatable and challenging. The majority of the cases are treated at childhood as clinical presentation is striking at birth; hence, presentation in adulthood is extremely rare...
January 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
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