Purpose: We describe a staged approach for pelvic closure in patients with
cloacal exstrophy, and evaluate the technique for functional and cosmetic r
esults.
Materials and Methods: Staged closure of the pelvis was performed in 5 pati
ents 12 months to 14 years old with cloacal exstrophy at our institution, i
ncluding some referred with a history of failed closure. The technique invo
lves initial pelvic osteotomy followed by soft tissue and pelvic ring closu
re 2 to 3 weeks later. Clinical information is reviewed to assess the effec
tiveness of the technique.
Results: At a mean followup of 3.2 years (range 1 to 9) closure was success
ful in all 5 patients without technical problems or surgical complications,
and with excellent functional and cosmetic results.
Conclusions: This technique of staged pelvic closure may provide reliable i
nitial or secondary repair in patients with cloacal exstrophy in whom 1-sta
ge pelvic closure is unfeasible even with pelvic osteotomy.