We herein describe the operative approach of a postmenopausal woman with a history of surgically corrected congenital bladder exstrophy-epispadias who presented with long-standing complete procidentia. The patient was initially treated by laparoscopic sacral colpopexy in conjunction with a modified Elevate mesh kit anterior vaginal repair with and posterior vaginal wall repair in the form of native tissue suture plication repair. Her prolapse recurred 8 months' later due to a detachment of the mesh at the level of the promontorium. During the second-look laparoscopy, a resuspension of this mesh was deemed unsatisfactory; therefore, with patients' consent, a successful colpocleisis was performed. This case report emphasizes the complexity of pelvic organ prolapse (POP) in the context of a bladder exstrophy-epispadias complex. These women are more likely to fail the more conventional current surgical treatments for POP, coercing to revert to colpocleisis.
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http://dx.doi.org/10.4103/GMIT.GMIT_14_18 | DOI Listing |
Urol J
January 2025
Pediatric Urology and Regenerative Medicine Research Center, Gene, Cell and Tissue Research Institute, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Purpose: To evaluate the effectiveness of the Complete Primary Repair of Exstrophy (CPRE) technique for bladder exstrophy-epispadias complex (BEEC) reconstruction and its comparison with the Modern Staged Repair of Exstrophy (MSRE) technique.
Materials And Methods: A comprehensive literature review of CPRE and MSRE was conducted, focusing on factors such as continence rates, postoperative outcomes, and complications. Various studies on pelvic biometry, surgical approaches, and long-term evaluations of renal function and continence were analyzed.
Afr Urol
June 2024
Division of Urology, Department of Surgery, University of Utah School of Medicine, United States of America.
Bladder exstrophy-epispadias-cloacal exstrophy complex (BEEC) is a spectrum of congenital urologic anomalies that involve the bladder, urethra, genitalia, and pelvic musculoskeletal system, and can affect urinary continence, sexual health, and fertility. BEEC includes a wide spectrum of anatomical abnormalities with different levels of severity: epispadias represents the mildest phenotype, classic bladder exstrophy (CBE) is the most common defect, and cloacal exstrophy (CE) - often referred to as omphalocele, exstrophy, imperforate anus, and spinal defects (OEIS) complex - is the most severe form. BEEC disorders cause significant health problems and affect the health-related quality of life (QoL) of affected individuals.
View Article and Find Full Text PDFJ Pediatr Orthop
December 2024
Paediatric Urology, Royal Manchester Children's Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
Cells
November 2024
Akron Nephrology Associates, Cleveland Clinic Akron General Medical Center, Akron, OH 44307, USA.
Congenital anomalies of the kidney and urinary tract (CAKUT) represent a broad range of diseases with differing mechanisms, clinical presentations, and prognoses. With an estimated prevalence of between 4 and 60 per 10,000 births, CAKUT represents a sizable number of patients for pediatric and adult nephrologists as therapies have progressed, allowing longer life spans. Many CAKUT disorders are associated with genetic mutations, and with advances in genomic sequencing, these genes are being identified at an increasing rate.
View Article and Find Full Text PDFJ Pediatr Urol
November 2024
Department of Urology, School of Medicine, University of California San Francisco, 400 Parnassus Ave, San Francisco, CA, 94143, USA; Department of Surgery, San Francisco Veterans Affairs Medical Center, 4150 Clement St, San Francisco, CA, 94121, USA.
Background: Exstrophy-epispadias complex (EEC) classically presents as bladder exstrophy (BE) and requires lifetime urologic care. As men and women with BE age, there is an often difficult period of transition to adulthood in terms of addressing urologic and general health challenges. BE can lead to many urinary and sexual health issues as these patients age, which is often made more complex given their past surgical history and anatomy.
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