WOFAPS 2025 8th World Congress of Pediatric Surgery

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OUR INITIAL EXPERIENCE OF SINGLE STAGE REPAIR OF BLADDER EXSTROPHY BY MODIFIED CPRE IN NEONATES: CONTRADICTING THE CONTRARY.

Ameerjan Shaik 1, Santosh Baburao Kurbet 1, Prashanth P Gowda 2
1 KAHER's JN MEDICAL COLLEGE BELGAVI
2 *College of Medicine and Health Sciences, National University of Science and Technology, Al Tareef, Sohar, Muscat, Sultanate of Oman.

Objectives:To study the surgical experience, problems faced and the follow-up of complete primary-repair of-exstrophy (CPRE) technique in newborns. We report our initial-experience with CPRE and its short and intermediate-term outcomes with respect to cosmesis, functional-results, continence-status and psychosocial-impact.

Methods:A retrospective review of the hospital records from March 2008 to December 2020 at our tertiary-care centre was performed. Data on the patients with bladder exstrophy managed by a single pediatric surgeon using CPRE technique were analyzed. Complete primary repair of exstrophy (CPRE) was done using modified Mitchell’s technique. Postoperatively, patients were followed prospectively for clinical outcomes, imaging studies and scarring on DMSA renal scan. Urodynamic status, urinary continence status and episodes of urinary tract infections were documented regularly.

Results:Two patients experienced early post-operative complications. All the patients were doing well in follow up period with variable continence rates, one partial dehiscencerequired redosurgery but rest have good cosmesis and are socially acceptable with acceptable PQLI.

Conclusions: Although the modern staged repair of exstrophy (MSRE) is currently favoured, complete primary repair of exstrophy (CPRE) potentially provides socially acceptable continence in single stage surgery. CPRE decreases the number of operations, is safe and efficacious even in the newborns.Continence is difficult to achieve but it is also possible to provide some patients with what we call ‘socially acceptable continence’. However, we need long-term follow-up studies to compare the results of CPRE and those with staged-repair in exstrophy-bladders of Indian population.

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