[Reconstructive-plastic surgery in bladder exstrophy].

Among 234 children with exstrophy of the urinary bladder 112 were subjected to reconstructive-plastic operation after G. A. Pair. A good result was produced in 71 cases. In 27 children a satisfactory result was attained only after repeated operations. Reconstructive-plastic interventions had no positive effect in 14 children. By means of electrophysiological and morphological methods three degrees of underdevelopment of the muscular coat of an urinary bladder affected by exstrophy were distinguished. In I degree plastics of the bladder with local tissues is indicated, in II degree the indications are relative, in III degree a plastic operation is not indicated. Choice of the operative method on basis of the morphofunctional condition of the bladder with exstrophy, the use of microsurgical techniques, the formation of a closed pelvic ring, and antireflux operations on the ureters improve the immediate and late-term results of reconstructive-restorative surgical interventions.