Short description:

This book brings together contemporary experts in bladder exstrophy-epispadias from around the world to present evidence-based recommendations for managing this anomaly from prenatal diagnosis, postnatal management, surgical reconstruction, long-term management, sexual and fertility implications, and psychosocial impacts on the patient, family and immediate community ecosystem. Bladder exstrophy and epispadias is relatively rare in its incidence, but remains, perhaps, the most complex congenital anomaly faced by pediatric urologists. When presented with an infant with this anomaly, there remains great controversy in every aspect of management of this disorder—from what causes it, to when it should be repaired, to how it should be repaired, and what long-term management should entail. Pediatric urologists are only now beginning to seriously explore new strategies in dealing with bladder exstrophy, and long-term studies are being initiated and completed presenting a clearer picture on how this anomaly—with serious long-term consequences—should be managed. Moreover, bladder exstrophy is a global problem and its incidence is greater in the developing world.

Bladder Exstrophy and Epispadias: A Compendium begins by covering diagnosis and imaging, followed by surgical considerations and expected outcomes of repair. From here, various surgical repair methods, like complete primary repair, modern staged repair, Kelly repair, and various alternative approaches are covered in detail. A video library offering step by step depictions of each of the surgical approaches for bladder exstrophy, epispadias and cloacal exstrophy repairs offers the reader a distinct, invaluable resource. This book is unique in including a global perspective on how this condition should be addressed in the face of disparities in access to care—especially in the Global South. Finally, a discussion of long-term results and the gynecological implications of exstrophy leads into a view of the patient and family perspective.

This is an ideal guide for urologists, pediatric urologists, surgeons, and students to be able to successfully diagnose, treat, and manage bladder exstrophy and epispadias.

Long description:

This book brings together contemporary experts in bladder exstrophy-epispadias from around the world to present evidence-based recommendations for managing this anomaly from prenatal diagnosis, postnatal management, surgical reconstruction, long-term management, sexual and fertility implications, and psychosocial impacts on the patient, family and immediate community ecosystem. Bladder exstrophy and epispadias is relatively rare in its incidence, but remains, perhaps, the most complex congenital anomaly faced by pediatric urologists. When presented with an infant with this anomaly, there remains great controversy in every aspect of management of this disorder—from what causes it, to when it should be repaired, to how it should be repaired, and what long-term management should entail. Pediatric urologists are only now beginning to seriously explore new strategies in dealing with bladder exstrophy, and long-term studies are being initiated and completed presenting a clearer picture on how this anomaly—with serious long-term consequences—should be managed. Moreover, bladder exstrophy is a global problem and its incidence is greater in the developing world.

Bladder Exstrophy and Epispadias: A Compendium begins by covering diagnosis and imaging, followed by surgical considerations and expected outcomes of repair. From here, various surgical repair methods, like complete primary repair, modern staged repair, Kelly repair, and various alternative approaches are covered in detail. A video library offering step by step depictions of each of the surgical approaches for bladder exstrophy, epispadias and cloacal exstrophy repairs offers the reader a unique, invaluable resource. This book is unique in including a global perspective on how this condition should be addressed in the face of disparities in access to care—especially in the Global South. Finally, a discussion of long-term results and the gynecological implications of exstrophy leads into a view of the patient and family perspective.

This is an ideal guide for urologists, pediatric urologists, surgeons, and students to be able to successfully diagnose, treat, and manage bladder exstrophy and epispadias.

Table of Contents:

Epidemiology and Embryology of the Bladder Exstrophy – Epispadias Complex.- Bladder exstrophy – epispadias complex (BEEC): Prenatal Diagnosis and Counseling.- Bladder Exstrophy Genetics – Our Current Understanding.- Prenatal and Postnatal Imaging of the Epispadias-Exstrophy Complex.- Surgical Considerations—Indications and Timing for Surgery (Defining Outcomes and Expectations of Exstrophy Repair).- Complete Primary Repair of Bladder Exstrophy.- The Modern Staged Repair of Classic Bladder Exstrophy.- The Kelly procedure.- Scroto-Perineal Appraoch to Bladder Exstrophy Repair.- Surgical Management of Male Classic Bladder Exstrophy – the Toronto Approach.- Modified Perineal Approach to Repair Female Epispadias.- Bladder Exstrophy and Epispadias Complex: A Compendium.- Common Adjuvant Surgeries in Exstrophy/ Epispadias Care.- Continent Anal Urinary Diversions in Bladder Exstrophy.- Cloacal Exstrophy.- Male Epispadias.- The Failed Exstrophy Repair: Technique and Implications.- Perioperative Management of Bladder Exstrophy.- Exstrophy as a Global Health Concern: Strategies for Addressing the Burden of Disease.- Incontinence in Exstrophy-Epispadias: Should we change our thinking?.- Surgical Options for Refractory Urinary Incontinence in Classic Bladder Exstrophy.- Urinary Reconstruction in the Developing World--Special Consideration and Technique.- Kidney and Bladder Exstrophy--Considerations and Caution.- Role of nursing in the early care of patients with bladder exstrophy.- The Impact of Physical Therapy on the Bladder Exstrophy-Epispadias Complex.- Psychological Implications of Bladder Exstrophy-Epispadias.- Reproductive and Sexual Health in Bladder Exstrophy.- Gynecological Implications of Exstrophy.- Advocacy for the Exstrophy Patient and Community: Empowering and Encouraging the Patient and Family.