Pathogenesis of bladder exstrophy: A new hypothesis

Journal of Pediatric Urology
Satish Kumar K VKarthikeya K Varma

Abstract

Classical bladder exstrophy affects 1 in 30 000 live births. Results of surgical treatment from different institutions employing various surgical techniques are not uniform, thus there is a need for a consensus on the best technique for bladder exstrophy repair. Surgical correction in bladder exstrophy would be more effective if the exact pathogenetic mechanism was deduced and the procedure was directed to correct the cause, which is responsible for the defect. The anatomy of exstrophy shows that the infraumbilical abdominal wall, the anterior wall of the bladder, and the urethra are split, with splayed out genitalia and musculature along with pubic diastasis. There is no tissue loss and hence embryological defect is unlikely to be the cause of bladder exstrophy. Thus there is a need to examine pathogenesis of bladder exstrophy. A literature search was made of the various hypotheses for cause of bladder exstrophy, and attempts were made to propose a new hypothesis. The present hypothesis is also the basis for a technique of mobilization of pelvic musculature, done in two stages. The functional outcomes of 38 children with bladder exstrophy managed over a period of 10 years were reviewed. At a mean follow-up of 4.5 years (range ...Continue Reading

References

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Sep 25, 2015·International Braz J Urol : Official Journal of the Brazilian Society of Urology·Hajar KhosravanianNarges Khosravanian

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Citations

May 26, 2016·Birth Defects Research. Part A, Clinical and Molecular Teratology·Julia KolarovaReiner Siebert
Apr 25, 2017·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Michal Fishel-BartalYinon Gilboa
Oct 14, 2020·Urology·Saran A HallJohn P Gearhart
Mar 3, 2021·Journal of Perinatology : Official Journal of the California Perinatal Association·Federico MecariniGiangiorgio Crisponi

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