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Case Reports
. 2015 Oct;5(2):e183-7.
doi: 10.1055/s-0035-1556759. Epub 2015 Sep 7.

Exstrophy-Epispadias Complex in a Newborn: Case Report and Review of the Literature

Enrico Valerio  1 , Valentina Vanzo  1 , Patrizia Zaramella  1 , Sabrina Salvadori  1 , Marco Castagnetti  2 , Eugenio Baraldi  1
Affiliations
Case Reports

Exstrophy-Epispadias Complex in a Newborn: Case Report and Review of the Literature

Enrico Valerio et al. AJP Rep. 2015 Oct.

Abstract

Aim The aim of this report is to present a brief review of the current literature on the management of EEC. Case Report A term male neonate presented at birth with classic bladder exstrophy, a variant of the exstrophy-epispadias complex (EEC). The defect was covered with sterile silicon gauzes and waterproof dressing; at 72 hours of life, primary closure without osteotomy of bladder, pelvis, and abdominal wall was successfully performed. Discussion EEC incidence is approximately 2.15 per 1,00,000 live births; several urological, musculocutaneous, spinal, orthopedic, gastrointestinal, and gynecological anomalies may be associated to EEC. Initial medical management includes use of occlusive dressings to prevent air contact and dehydration of the open bladder template. Umbilical catheters should not be positioned. Surgical repair stages include initial closure of the bladder and abdominal wall with or without osteotomy, followed by epispadias repair at 6 to 12 months, and bladder neck repair around 5 years of life. Those who fail to attain continence eventually undergo bladder augmentation and placement of a catheterizable conduit. Conclusion Modern-staged repair of EEC guarantees socially acceptable urinary continence in up to 80% of cases; sexual function can be an issue in the long term, but overall quality of life can be good.

Keywords: congenital disease; exstrophy–epispadias complex; neonatology; newborn; urology.

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Conflict of interest statement

Conflicts of Interest None.

Figures

Fig. 1
Fig. 1
Male newborn with classic bladder exstrophy. Exposed, everted bladder template is clearly visible immediately below umbilical stump; a completely dorsally opened (epispadic) urethral plate runs from bladder neck down to the open glans; left and right corpora cavernosa are visible beneath and alongside urethral plate; the scrotum is caudally displaced.
Fig. 2
Fig. 2
Postoperative patient immobilization with pelvis and lower limbs wrapped around and suspended in a special hammock device (modified Bryant traction).
See this image and copyright information in PMC

References

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