Cloacal Exstrophy: a complex disease
Autor(a) principal: | |
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Data de Publicação: | 2013 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://dx.doi.org/10.1590/S1677-5538.IBJU.2013.06.19 http://repositorio.unifesp.br/handle/11600/8065 |
Resumo: | Introduction Cloacal exstrophy is a rare occurrence with an incidence of 1:200,000 to 1:400,000 live births. It represents one of the most challenging reconstructive endeavors faced by pediatric surgeons and urologists. Aside from the genitourinary defects, there are other associated anomalies of the gastrointestinal, musculoskeletal and neurological systems that require a multidisciplinary approach when counseling anxious parents. Material and Methods We present a video of a patient with cloacal exstrophy treated with 21 days of life. Surgery consisted of separation and tubularization of the cecal plate from the exstrophied bladder halves and colostomy construction. The bladder was closed primarily and umbilical scar reconstructed and used for ureteral and cistostomy drainage. A urethral catheter was used to guide bladder neck tubularization. A final epispadic penis was obtained and planned for further repair in a second step. Results The patient had an initial uneventful postoperative course and immediate outcome was excellent. The bladder healed nicely but patient presented with abdominal distension in the 5th day of postoperative setting requiring parenteral nutrition. The distal colon persisted with lower diameter although non obstructive, but causing difficulty for fecal progression. Continuous colostomy dilatation and irrigation were required. Conclusions Approximating the bladder halves in the midline at birth and primary bladder closure is a viable option, intestinal transit may be a issue of concern in the early postoperative follow-up. |
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Cloacal Exstrophy: a complex diseaseIntroduction Cloacal exstrophy is a rare occurrence with an incidence of 1:200,000 to 1:400,000 live births. It represents one of the most challenging reconstructive endeavors faced by pediatric surgeons and urologists. Aside from the genitourinary defects, there are other associated anomalies of the gastrointestinal, musculoskeletal and neurological systems that require a multidisciplinary approach when counseling anxious parents. Material and Methods We present a video of a patient with cloacal exstrophy treated with 21 days of life. Surgery consisted of separation and tubularization of the cecal plate from the exstrophied bladder halves and colostomy construction. The bladder was closed primarily and umbilical scar reconstructed and used for ureteral and cistostomy drainage. A urethral catheter was used to guide bladder neck tubularization. A final epispadic penis was obtained and planned for further repair in a second step. Results The patient had an initial uneventful postoperative course and immediate outcome was excellent. The bladder healed nicely but patient presented with abdominal distension in the 5th day of postoperative setting requiring parenteral nutrition. The distal colon persisted with lower diameter although non obstructive, but causing difficulty for fecal progression. Continuous colostomy dilatation and irrigation were required. Conclusions Approximating the bladder halves in the midline at birth and primary bladder closure is a viable option, intestinal transit may be a issue of concern in the early postoperative follow-up.Universidade Federal de São Paulo (UNIFESP) Division of UrologyUNIFESP, Division of UrologySciELOSociedade Brasileira de UrologiaUniversidade Federal de São Paulo (UNIFESP)Macedo Jr, AntonioRondon, AtilaFrank, RicardoBacelar, HerickLeslie, BrunoOttoni, SergioGarrone, GilmarLiguori, RibertoOrtiz, Valdemar [UNIFESP]2015-06-14T13:45:43Z2015-06-14T13:45:43Z2013-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion897-898application/pdfhttp://dx.doi.org/10.1590/S1677-5538.IBJU.2013.06.19International braz j urol. Sociedade Brasileira de Urologia, v. 39, n. 6, p. 897-898, 2013.10.1590/S1677-5538.IBJU.2013.06.19S1677-55382013000600897.pdf1677-5538S1677-55382013000600897http://repositorio.unifesp.br/handle/11600/8065engInternational braz j urolinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-07-30T02:39:19Zoai:repositorio.unifesp.br/:11600/8065Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-07-30T02:39:19Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.none.fl_str_mv |
Cloacal Exstrophy: a complex disease |
title |
Cloacal Exstrophy: a complex disease |
spellingShingle |
Cloacal Exstrophy: a complex disease Macedo Jr, Antonio |
title_short |
Cloacal Exstrophy: a complex disease |
title_full |
Cloacal Exstrophy: a complex disease |
title_fullStr |
Cloacal Exstrophy: a complex disease |
title_full_unstemmed |
Cloacal Exstrophy: a complex disease |
title_sort |
Cloacal Exstrophy: a complex disease |
author |
Macedo Jr, Antonio |
author_facet |
Macedo Jr, Antonio Rondon, Atila Frank, Ricardo Bacelar, Herick Leslie, Bruno Ottoni, Sergio Garrone, Gilmar Liguori, Riberto Ortiz, Valdemar [UNIFESP] |
author_role |
author |
author2 |
Rondon, Atila Frank, Ricardo Bacelar, Herick Leslie, Bruno Ottoni, Sergio Garrone, Gilmar Liguori, Riberto Ortiz, Valdemar [UNIFESP] |
author2_role |
author author author author author author author author |
dc.contributor.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Macedo Jr, Antonio Rondon, Atila Frank, Ricardo Bacelar, Herick Leslie, Bruno Ottoni, Sergio Garrone, Gilmar Liguori, Riberto Ortiz, Valdemar [UNIFESP] |
description |
Introduction Cloacal exstrophy is a rare occurrence with an incidence of 1:200,000 to 1:400,000 live births. It represents one of the most challenging reconstructive endeavors faced by pediatric surgeons and urologists. Aside from the genitourinary defects, there are other associated anomalies of the gastrointestinal, musculoskeletal and neurological systems that require a multidisciplinary approach when counseling anxious parents. Material and Methods We present a video of a patient with cloacal exstrophy treated with 21 days of life. Surgery consisted of separation and tubularization of the cecal plate from the exstrophied bladder halves and colostomy construction. The bladder was closed primarily and umbilical scar reconstructed and used for ureteral and cistostomy drainage. A urethral catheter was used to guide bladder neck tubularization. A final epispadic penis was obtained and planned for further repair in a second step. Results The patient had an initial uneventful postoperative course and immediate outcome was excellent. The bladder healed nicely but patient presented with abdominal distension in the 5th day of postoperative setting requiring parenteral nutrition. The distal colon persisted with lower diameter although non obstructive, but causing difficulty for fecal progression. Continuous colostomy dilatation and irrigation were required. Conclusions Approximating the bladder halves in the midline at birth and primary bladder closure is a viable option, intestinal transit may be a issue of concern in the early postoperative follow-up. |
publishDate |
2013 |
dc.date.none.fl_str_mv |
2013-12-01 2015-06-14T13:45:43Z 2015-06-14T13:45:43Z |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1590/S1677-5538.IBJU.2013.06.19 International braz j urol. Sociedade Brasileira de Urologia, v. 39, n. 6, p. 897-898, 2013. 10.1590/S1677-5538.IBJU.2013.06.19 S1677-55382013000600897.pdf 1677-5538 S1677-55382013000600897 http://repositorio.unifesp.br/handle/11600/8065 |
url |
http://dx.doi.org/10.1590/S1677-5538.IBJU.2013.06.19 http://repositorio.unifesp.br/handle/11600/8065 |
identifier_str_mv |
International braz j urol. Sociedade Brasileira de Urologia, v. 39, n. 6, p. 897-898, 2013. 10.1590/S1677-5538.IBJU.2013.06.19 S1677-55382013000600897.pdf 1677-5538 S1677-55382013000600897 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
International braz j urol |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
897-898 application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Urologia |
publisher.none.fl_str_mv |
Sociedade Brasileira de Urologia |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
collection |
Repositório Institucional da UNIFESP |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
biblioteca.csp@unifesp.br |
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1814268440228134912 |