Primary Reconstruction of Exstrophied Bladder after Anterior Pubic Osteotomy

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Primary Reconstruction of Exstrophied Bladder
after Anterior Pubic Osteotomy
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Uretric Opening
Female neonate with BE
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Bladder dissected from surrounding
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Bladder closed
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SPRO performed
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Recti approximated easily
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Skin closed
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Pubic Diastasis
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Closed Symphysis
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• Many drawbacks of posterior iliac osteotomy like
  the need for two additional incisions with
  increased risk for infection and blood loss,
  second is that the patient must be turned from
  the prone to the supine position which entails
  additional risk.

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• Third, a great force is needed to approximate the
  entire hemipelvis. Lastly, posterior iliac
  osteotomy is attended with proximal migration of
  the hemipelvis with subsequent leg length
  inequality.

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• On the other hand SPRO is safe and efficacious
  technique to obtain tension free approximation of
  the pelvic ring in B.E. repair with a similar
  results to those obtained with more complicated
  osteotomies.

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Thank You