Safety and efficacy of spica casts for immobilization following initial bladder closure in classic bladder exstrophy

Journal of Pediatric Urology
Angela M ArlenJ Christopher Austin

Abstract

Pelvic immobilization constitutes a necessary component of successful bladder exstrophy closure. The efficacy of spica cast immobilization has been reported as markedly inferior to external fixation, with success rates below 25%. We reviewed our experience with spica cast immobilization following bladder closure. We retrospectively reviewed classic bladder exstrophy patients undergoing bladder closure with spica cast immobilization. Success of bladder closure and complications related to immobilization were noted, as were age, type of closure, use of osteotomy, duration of immobilization, and number of cast changes. Fifteen patients underwent bladder closure (10 staged, 5 complete repair) at a median age of 4 days (range 1-6) and 14 were immobilized with spica casts. Initial closures were successful in 11 (73%). Success rates were higher in patients undergoing osteotomies (6/7, 86%) compared to those without osteotomies (5/8, 63%). No patients immobilized with spica casts developed serious complications related to their immobilization. Minor skin breakdown occurred in 3/14 patients (21%). Median time of immobilization was 39 days (range 22-48). Spica casts are a safe, effective method of postoperative immobilization and are ass...Continue Reading

References

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Aug 22, 2008·The Journal of Urology·Anthony J SchaefferJohn P Gearhart
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Citations

Nov 7, 2014·Surgery Research and Practice·Brian M InouyeJohn P Gearhart
Aug 27, 2014·Clinics in Perinatology·Angela M Arlen, Edwin A Smith
May 21, 2013·Current Urology Reports·Brian M InouyeJohn P Gearhart
May 3, 2012·International Journal of Alzheimer's Disease·Beata FerenczGrégoria Kalpouzos
Nov 23, 2011·Journal of Pediatric Urology·Kristina D SusonJohn P Gearhart
Jul 3, 2013·The Journal of Urology·M Chad WallisPatrick C Cartwright
Oct 11, 2016·The Journal of Urology·Pokket SirisreetreeruxJohn P Gearhart
Feb 25, 2017·Current Urology Reports·Elizabeth RothTravis Groth

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