Our Experience with Pelvic Osteotomy in Bladder Exstrophy

Abstract

Aim. To analyze the effectiveness of pelvic osteotomy in bladder exstrophy.

Materials and Methods. The study analyzed data from 30 patients with bladder exstrophy who received treatment in the Department of Pediatric Urology at the National Children’s Medical Center between October 2022 and June 2024. The age of patients ranged from 3 months to 10 years. Among them, 21 were boys (69%) and 9 were girls (31%), with a gender ratio of 2:1. Out of these 30 patients, 25 underwent surgical correction with Salter pelvic osteotomy using different fixation methods. In 13 patients, osteotomy and pelvic fixation were performed with pins and plaster cast, while in 12 patients, osteotomy and external fixation were applied. One patient underwent posterior osteotomy, and 4 patients underwent modern surgical correction of bladder exstrophy without pelvic osteotomy.

Results. Briefly summarize the main findings of the article.

Conclusion. Pelvic osteotomy in bladder exstrophy, performed during primary closure, provides several advantages: approximation of the symphysis with reduced tension during abdominal wall closure without the need for fascial flaps; placement of the posterior vesico-urethral complex deep within the pelvic ring, which increases the bladder’s outlet resistance; and approximation of the major pelvic floor muscles to the midline, where they can support the bladder neck and ultimately contribute to urinary continence.