Staged repair of exstrophy-epispadias complex cases with initial bladd
er closure followed by epispadias and bladder neck repair at a later d
ate is well documented. However, the role of single stage repair as a
primary and salvage procedure after failed closure is not well establi
shed. A total of 12 male patients with bladder exstrophy has undergone
single stage repair at our facility (10 secondary and 2 primary proce
dures). Mean age of the 10 patients referred for secondary repair was
5.5 years (8 months to 13 years). In this group there had been 16 prev
iously unsuccessful attempts at bladder closure and 15 operations for
epispadias repair. The 2 primary repair patients were 15 months and 13
years old. Continence was achieved by bladder neck reconstruction com
bined with epispadias repair and all cases were augmented by enterocys
toplasty in conjunction with a Mitrofanoff channel. Pelvic osteotomy w
as performed in 3 cases. After bladder neck revision in 2 children all
are dry day and night on clean intermittent catheterization and have
a satisfactory cosmetic appearance. Single stage reconstruction of the
exstrophy complex is a satisfactory method with a low morbidity for t
reating children in whom previous repair has failed. Its more extended
role in the primary case requires further evaluation.