Indications and Types of Bladder Augmentation in Cloacal Exstrophy
Cloacal exstrophy is the most severe form of the bladder exstrophy complex. It represents the greatest challenge because not only is the bladder, bladder neck, urethra, and genitalia involved with this deformity and malformation, but the intestine may be severely shortened and innervation to the bladder and bladder neck area may be abnormal because of spinal malformation (present in greater than 75% of these patients). Therefore, reconstruction for urinary continence is a major challenge.
Stomach or a combination of stomach with small bowel may be ideal for bladder reconstruction in these patients. Large bowel or hindgut should not be used for the bladder. The advantage of stomach is that it has a structure similar to normal bladder, thus facilitating ureteral reimplantation or tunnels for continence.
KeywordsSmall Bowel Bladder Neck Primary Closure Intermittent Catheterization Urinary Continence
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