The Exstrophy—Epispadias Complex

1. Front Matter

   Pages i-xi

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2. The Embryology and Epidemiology of Bladder Exstrophy

   • Bruce Slaughenhoupt

   Pages 1-4

3. Prenatal Diagnosis of Bladder and Cloacal Exstrophy and Related Conditions

   • Roger C. Sanders

   Pages 5-8

4. Anatomy and Biomechanics of the Pelvis in Exstrophy

   • Mihir M. Jani, Paul D. Sponseller, John P. Gearhart, A. Valdevit, E. Y.-S. Chao

   Pages 9-15

5. Detrusor Morphology and Innervation in Bladder Exstrophy

   • J. A. Gosling, R. Mathews, J. P. Gearhart

   Pages 17-23

6. The Response of the Bladder Smooth Muscle to Increased Bladder Neck Resistance

   • Edward J. Macarak, Stephen Zderic, Howard M. C. Snyder, Douglas Canning, Pamela S. Howard

   Pages 25-31

7. Muscarinic Cholinergic Receptors in Bladder Exstrophy

   • Ellen Shapiro, Robert D. Jeffs, John P. Gearhart, Herbert Lepor

   Pages 33-39

8. A Quantitative Histological Analysis of the Bladder in Classical Bladder Exstrophy in Various Stages of Reconstruction Utilizing Color Morphometry

   • Dennis S. Peppas, Marie-Blanche Tchetgen, Benjamin R. Lee, Robert D. Jeffs, John P. Gearhart

   Pages 41-47

9. Analysis of Smooth Muscle and Collagen Subtypes in the Normal Newborn and Bladder Exstrophy Patient

   • Benjamin R. Lee, Elizabeth J. Perlman, Alan W. Partin, Robert D. Jeffs, John P. Gearhart

   Pages 49-55

10. A Large Animal Model of Bladder Exstrophy

    • Bruce L. Slaughenhoupt, John P. Gearhart

    Pages 57-61

11. Tissue Engineering Techniques for Closure of Bladder Exstrophy

    • Anthony Atala

    Pages 63-64

12. Surgical Principles in the Primary Closure of Bladder Exstrophy

    • John P. Gearhart, Ranjiv Mathews

    Pages 65-67

13. Anterior and Posterior Innominate Osteotomy in Exstrophy Repair

    • Paul D. Sponseller, John P. Gearhart, Mihir M. Jani, Robert D. Jeffs

    Pages 69-75

14. Bladder Exstrophy Closure without Osteotomy in Philadelphia

    • Douglas A. Canning, Thomas Lanchoney, Simone McKitty, Stephen Zderic, Howard M. Snyder III, John W. Duckett Jr.

    Pages 77-82

15. Bilateral Anterior Pubic Osteotomy in Bladder Exstrophy Closure

    • Peter Frey

    Pages 83-91

16. The Failed Exstrophy Closure

    • John P. Gearhart, Ranjiv Mathews

    Pages 93-96

17. Applications of Ureterosigmoidostomy in Bladder Exstrophy

    • Raimund Stein, Margit Fisch, Rudolf Hohenfellner

    Pages 97-103

18. Cystoplasty in Bladder Exstrophy

    • Steven G. Docimo

    Pages 105-110

19. Bladder Exstrophy

    • Sami Arap, Amilcar M. Giron

    Pages 111-115

20. Penile Length in Adulthood after Exstrophy Reconstruction

    • Richard I. Silver, Andrew Yang, Jacob Ben-Chaim, Robert D. Jeffs, John P. Gearhart

    Pages 117-125

The undertaking of the treatment of an infant born with bladder exstrophy is one of the most weighty responsibilities that can fall upon the shoulders of the reconstructive sur­ geon. The modern treatment of a child born with bladder exstrophy began in the mid- 1970's with the widespread application of staged reconstruction. This approach has consistently yielded very good results in several series. However, as in all serious congeni­ tal birth defects, there is certainly room for advancement. Issues such as the routine use of osteotomy, timing and type of epispadias repair, combining bladder closure with epispadias repair, the approach to the small bladder, and the management of a failed exstrophy still remain. This National Institute of Health/Na­ tional Kidney Foundation/Johns Hopkins-sponsored seminar was an attempt to bring ex­ perts in the field of pediatric orthopedic surgery, pediatric urology, pediatric surgery, adult urology, and basic science together to share their experiences in an attempt to foster new clinical and basic science research communications between the participants. If these col­ laborations result, then this first international meeting will have been successful. The editors would like to thank all of the contributors for their timely and complete submissions. John P. Gearhart, M.D. Ranjiv Mathews, M.D. vii CONTENTS 1. The Embryology and Epidemiology of Bladder Exstrophy ................. .

• anatomy
• embryology
• fertility
• osteotomy
• pathophysiology
• physiology
• tissue

• Johns Hopkins Medical Institutions, Baltimore, USA

  John P. Gearhart

• SUNY Health Science Center at Syracuse, Syracuse, USA

  Ranjiv Mathews

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