The Failed Exstrophy Closure

Strategies for Management—the Johns Hopkins Experience
  • John P. Gearhart
  • Ranjiv Mathews


Secure initial bladder closure is a critical first step in the reconstruction of the patient with bladder exstrophy. The potential for gain in bladder capacity to allow later bladder neck reconstruction (BNR) appears to be dependent on success of initial closure. Increases in bladder capacity occurred more rapidly and higher continence rates (83%) correlated with successful primary closure.1 Once primary repair fails the potential for continence drops markedly. With more than two failed closures only 23% of patients gain adequate capacity for BNR and only 50% of these attain continence.2


Outlet Obstruction Bladder Capacity Urethral Stricture Johns Hopkins Hospital Pediatric Urology 
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Copyright information

© Springer Science+Business Media New York 1999

Authors and Affiliations

  • John P. Gearhart
    • 1
    • 2
  • Ranjiv Mathews
    • 2
  1. 1.Division of Pediatric UrologyBrady Urological InstituteBaltimoreUSA
  2. 2.James Buchanan Brady Urological Institute Division of Pediatric UrologyJohns Hopkins Hospital and School of MedicineBaltimoreUSA

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