A COMBINED VERTICAL AND HORIZONTAL PELVIC OSTEOTOMY APPROACH FOR PRIMARY AND SECONDARY REPAIR OF BLADDER EXSTROPHY

Purpose: We describe a new combined horizontal and vertical pelvic ost eotomy procedure for bladder exstrophy. Materials and Methods: A total of 36 patients with the bladder exstrophy complex underwent this proc edure during a 3-year period (8 primary and 18 secondary bladder closu res, and 6 at bladder neck reconstruction). Results: There were no ins tances of dehiscence and only a minor bladder prolapse in 1 patient wi th cloacal exstrophy. Two patients had a transient femoral nerve palsy and there was 1 superficial pin infection. Urological complications i ncluded symptomatic urinary tract infections in 5 patients, acute epid idymitis in 1 and bladder calculi in 2. Conclusions: This new osteotom y procedure is of great benefit in initial or repeat closure of bladde r exstrophy and may help in eventually achieving continence.