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Bladder and Cloacal Exstrophy

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Abstract

Bladder exstrophy is a rare condition, resulting from a failure of fusion of midline tissues at the lower abdominal region (including the anterior urogenital elements), wherein the inner surface of the urethra and posterior bladder wall are exposed anteriorly, associated with bilateral hemipelvic posterolateral rotation, a substantial pubic diastasis, and a deficient lower abdominal wall. The goals of treatment include a successful primary closure and the eventual achievement of urinary continence. Successful and sustained urogenital reconstruction is dependent on a tension-free closure of the anterior soft tissues, facilitated by pelvic osteotomies, to avoid wound dehiscence and need for revision surgery. This chapter will offer a comprehensive review of the associated musculoskeletal and urogenital pathoanatomy, clinical aspects and natural history, for both classic bladder exstrophy and cloacal exstrophy, as well as a description of pelvic osteotomy techniques. A brief overview of the principles of urogenital reconstruction in bladder exstrophy will also be covered.

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Author information

Authors and Affiliations

  1. Weill Cornell Medicine, Chief of Orthopaedic Surgery, Sidra Medicine, Doha, Qatar

    Jason J. Howard

  2. Senior Attending Physician in Pediatric, Orthopedic Surgery, Sidra Medicine, Doha, Qatar

    James S. Huntley

  3. Vanderbilt University Medical Center, Jeffrey Mast Chair of Orthopaedic Hip and Trauma Surgery, Nashville, TN, USA

    Jonathan G. Schoenecker

  4. Clinical Director of Paediatric Trauma and Orthopaedic Surgery, Royal Manchester Children Hospital, Manchester University NHS Foundation Trust, Manchester, UK

    Sattar Alshryda

  5. Division of Urology, Sidra Medicine, Doha, Qatar

    Joao Pippi Salle

Authors
  1. Jason J. Howard
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  2. James S. Huntley
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  3. Jonathan G. Schoenecker
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  4. Sattar Alshryda
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  5. Joao Pippi Salle
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Editor information

Editors and Affiliations

  1. Clinical Director of Paediatric Trauma and Orthopaedic Surgery, Royal Manchester Children Hospital, Manchester University NHS Foundation Trust, Manchester, UK

    Sattar Alshryda

  2. Weill Cornell Medicine, Chief of Orthopaedic Surgery Sidra Medicine, Doha, Qatar

    Jason J. Howard

  3. Senior Attending Physician in Pediatric Orthopedic Surgery, Sidra Medicine, Doha, Qatar

    James S. Huntley

  4. Vanderbilt University Medical Center, Jeffrey Mast Chair of Orthopaedic Hip and Trauma Surgery, Nashville, TN, USA

    Jonathan G. Schoenecker

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Howard, J.J., Huntley, J.S., Schoenecker, J.G., Alshryda, S., Salle, J.P. (2019). Bladder and Cloacal Exstrophy. In: Alshryda, S., Howard, J., Huntley, J., Schoenecker, J. (eds) The Pediatric and Adolescent Hip. Springer, Cham. https://doi.org/10.1007/978-3-030-12003-0_34

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  • DOI: https://doi.org/10.1007/978-3-030-12003-0_34

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-12002-3

  • Online ISBN: 978-3-030-12003-0

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