Experience with urogenital reconstruction of ischiopagus conjoined twins

Abstract

Purpose: Ischiopagus conjoined twins are joined at the lower chest or abdomen down to the pelvis. We review our experience with such patients at Children's Hospital of Philadelphia.

Materials and methods: Six sets of ischiopagus twins were separated and their treatment is discussed. In addition, reports on 36 sets of ischiopagus twins are reviewed.

Results: If a shared bladder is present, 1 twin retains it while the other receives a temporary urinary drainage system. Later, the twin without a bladder undergoes reconstruction to create a continent catheterizable pouch. When 4 kidneys are present the opposite ureter is reimplanted or crossed with transureteroureterostomy. Twins with 2 sets of genitalia can usually undergo separation and reconstruction appropriately. Occasionally single external genitalia are present and secondary reconstructive genitoplasty is required.

Conclusions: Multiple staged genital reconstructions are required but with proper planning satisfactory outcomes will result.