Raleigh Orthopaedic Clinic, Raleigh, NC, USA.
J Am Acad Orthop Surg. 2011 Sep;19(9):518-26. doi: 10.5435/00124635-201109000-00002.
Classic bladder exstrophy is an embryologic malformation that results in complex deficiency of the anterior midline, with urogenital and skeletal manifestations. Urogenital reconstruction is a challenging procedure that can be facilitated by closure of the bony pelvic ring by an orthopaedic team. Surgical options include a multiyear staged approach and the single-stage complete repair for exstrophy. The goals of urologic surgery include closure of the bladder and abdominal wall with eventual bladder continence, preservation of renal function, and cosmetic and functional reconstruction of the genitalia. Pelvic osteotomy is done at the time of bladder closure in the patient in whom the anterior pelvis cannot be approximated without tension. Traction or spica casting is used postoperatively. Good outcomes are probable with appropriate management at specialized treatment centers.
经典膀胱外翻是一种胚胎发育畸形，导致前中线复杂缺失，伴有泌尿生殖和骨骼表现。泌尿生殖重建是一项具有挑战性的手术，骨科团队可以通过闭合骨性骨盆环来辅助完成。手术选择包括多年分期方法和用于外翻的单一阶段完全修复。泌尿科手术的目标包括最终实现膀胱控尿，保留肾功能，以及生殖器的美容和功能重建来关闭膀胱和腹壁。如果在没有张力的情况下不能使前骨盆接近，在膀胱关闭时会对患者进行骨盆切开术。术后使用牵引或管形石膏固定。在专门治疗中心进行适当的管理，可能会获得良好的结果。
