The use of pelvic osteotomy in cloacal exstrophy

Cloacal exstrophy is the most severe congenital malformation within the exstrophy spectrum. Its successful treatment requires a dedicated multidisciplinary exstrophy team that includes a pediatric orthopedic surgeon familiar with the exstrophy complex. In 1995, Ben-Chaim et al (J Urol 1995;154:865-7) reported an 89% complication rate in those cloacal exstrophy patients closed primarily without a pelvic osteotomy and a 17% complication rate in those closed with an osteotomy. Therefore, the use of pelvic osteotomy is a well-established method of obtaining a successful cloacal exstrophy closure. This article reviews the different options available for pelvic osteotomy and stabilization of the pubic symphysis in patients with cloacal exstrophy.