Failed bladder exstrophy repair. Evaluation and management.

Early successful closure, careful management of the incontinent interval, and a good technical bladder neck reconstruction can result in a patient with normal control and upper tracts. However, failure at any step of a staged functional reconstruction does not doom the child to failure in the eventual achievement of the above goals. Nonetheless, taking care of the exstrophy failure is still a formidable task for the reconstructive surgeon. Currently, surgical techniques exist that can salvage the vast majority of these children. Careful evaluation of the failure, waiting an appropriate interval before further reconstructive surgery is attempted, and dedication to the patient most often can produce a successful result.