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The Exstrophy Complex: Bladder and Cloacal Exstrophy

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Abstract

The care of a newborn with the exstrophy-epispadias complex presents a formidable challenge to the pediatric surgical community. The approach to these children is a multi-disciplinary effort involving multiple subspecialties including urologists, surgeons, orthopedists, pediatric anesthesiologists and specialty nurses. Advances in the basic and clinical sciences in the past two decades have yielded insight into the embryologic, genetic, and the physiology of exstrophy. Despite multiple approaches to the surgical management of the exstrophic patients are used throughout the world, the critically important part of the surgical care is a successful primary closure. The best long-term outcomes can only be achieved with a successful primary closure, and each failure decreases a patient’s chance at voided continence. This chapter aims to examine all aspects of the exstrophy patient including the surgical management and long term prognosis.

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Authors and Affiliations

  1. Johns Hopkins Hospital, James Buchanan Brady Urological Institute, Baltimore, MD, USA

    Peter P. Stuhldreher MD

  2. James Buchanan Brady Urological Institute, Johns Hopkins Hospital, 600 N. Wolfe St, Marburg 135, Baltimore, MD, 21287, USA

    John P. Gearhart MD, FACS, FRCS(Hon) (Ed)

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  1. Peter P. Stuhldreher MD
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  2. John P. Gearhart MD, FACS, FRCS(Hon) (Ed)
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Correspondence to John P. Gearhart MD, FACS, FRCS(Hon) (Ed) .

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Editors and Affiliations

  1. Division of Child Health, Alder Hey Children’s NHS Foundation Trust, Liverpool, United Kingdom

    Paul D. Losty

  2. University of Pennsylvania , Philadelphia, Pennsylvania, USA

    Alan W. Flake

  3. Childrens Hospital, University of Helsinki, Helsinki, Finland

    Risto J. Rintala

  4. Royal Children’s Hospital, University of Melbourne, Parkville, Victoria, Australia

    John M. Hutson

  5. Department of Surgery, Meiji University of Integrative Medicine, Kyoto, Japan

    Naomi lwai

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Stuhldreher, P.P., Gearhart, J.P. (2018). The Exstrophy Complex: Bladder and Cloacal Exstrophy. In: Losty, P., Flake, A., Rintala, R., Hutson, J., lwai, N. (eds) Rickham's Neonatal Surgery. Springer, London. https://doi.org/10.1007/978-1-4471-4721-3_48

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