Objective: To describe the procedures and complications of bladder exstrophy closure, epispadias repair and bladder neck surgery to achieve urinary control.
Methods: Retrospective chart review of 11 patients with the exstrophy-epispadias complex.
Results: Early bladder closure is performed after birth with or without concomitant pelvic osteotomy. The preferred procedures are: the Cantwell-Ransley technique for epispadias repair, the Young-Dees-Leadbetter procedure for bladder neck reconstruction and ileocystoplasty with Mitrofanoff for bladder augmentation.
Conclusions: Augmentation and continent diversion procedures can increase the functional capacity of the exstrophic bladder, and allow the vast majority of patients to achieve continence and preserve renal function. Bladder lithiasis is the most significant complication in these patients.