Mobilization of pelvic musculature and its effect on continence in classical bladder exstrophy: A single-center experience of 38 exstrophy repairs

Neonatal bladder closure followed by mobilization and repair of the pelvic musculature, produce satisfactory continence in exstrophic children. Proper identification and repair of the external sphincter and levatorplasty correct the altered anatomy by relocating the bladder neck and posterior urethra deep in the pelvis, simulating normal micturition. Early neonatal bladder closure improves outcome. The results are reproducible if basic principles governing continence are followed and when done in a specialized centers.Table. Comparison of bladder exstrophy results employing similar techniques.Number/type of repairStudyNumber of patientsContinence (%)1 (Varma et al.)Present study (2013)3863.5a2 (Kelly's)Jarzebowski et al. J Urol 2009; 182:1802-6.3170b3 (Kelly's)Kelly Ped Surg Int 1995; 10:298-304.1973aPresent study: complete continence.bBoth partial and complete continence.