Cloacal Exstrophy: a complex disease

Detalhes bibliográficos
Autor(a) principal: Macedo Jr, Antonio
Data de Publicação: 2013
Outros Autores: Rondon, Atila, Frank, Ricardo, Bacelar, Herick, Leslie, Bruno, Ottoni, Sergio, Garrone, Gilmar, Liguori, Riberto, Ortiz, Valdemar [UNIFESP]
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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spelling 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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