Ultrastructure of the bladder in classic exstrophy: correlation with development of continence

The Journal of Urology
Ranjiv I MathewsJohn P Gearhart

Abstract

Successful initial surgical management of bladder exstrophy does not always lead to continence. We evaluated the ultrastructure of the exstrophic bladder using electron microscopy (EM) at various stages of reconstruction to determine whether morphology could correlate with the potential for continence. Bladder specimens obtained from 32 patients undergoing various stages of exstrophy reconstruction were evaluated by EM. Specimens were obtained at primary newborn closure (group 1-10), reclosure following failure (group 2-2), bladder neck reconstruction (group 3-9) and augmentation cystoplasty (group 4-11). Evaluation was performed by a single anatomist with experience with EM. Biopsies were separated into those with good, intermediate or poor ultrastructural parameters and then correlated clinically. In group 1, 4 children had good and 2 had intermediate parameters. All showed increased bladder volumes at followup. Four patients had poor parameters and poor bladder growth. The 2 group 2 children had poor parameters and bladder growth. In group 3, 7 of 9 patients had good and 1 had intermediate parameters. Eight of the 9 patients are doing well. Only 3 of the 11 group 4 children had good parameters and an additional 2 had interme...Continue Reading

References

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Citations

Aug 24, 2006·Der Urologe. Ausg. A·W H RöschG Schott
Mar 7, 2006·World Journal of Urology·C R J WoodhouseJohn P Gearhart
Apr 19, 2008·Current Urology Reports·Kurt R Eeg, Antoine E Khoury
Nov 3, 2009·Orphanet Journal of Rare Diseases·Anne-Karoline EbertWolfgang H Rösch
Jan 28, 2014·Journal of Pediatric Urology·Ali TourchiJohn P Gearhart
Oct 27, 2010·Pediatric Surgery International·Antonio ZaccaraPietro Bagolan
Oct 24, 2012·The Journal of Urology·Nima BaradaranJohn P Gearhart
Aug 23, 2011·The Journal of Urology·Nima BaradaranJohn P Gearhart
Jul 6, 2010·Urology·Ranjiv Mathews
Feb 16, 2010·Journal of Pediatric Urology·Marcus KufnerRanjiv Mathews
May 1, 2010·Neurourology and Urodynamics·C H FryL A Birder
Aug 9, 2016·Journal of Pediatric Urology·Sarah GiutronichYves Heloury

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