PMID- 18386019
OWN - NLM
STAT- MEDLINE
DCOM- 20081216
LR  - 20211020
IS  - 0179-0358 (Print)
IS  - 0179-0358 (Linking)
VI  - 24
IP  - 6
DP  - 2008 Jun
TI  - Comparison of musculoskeletal and urological functional outcomes in patients with 
      bladder exstrophy undergoing repair with and without osteotomy.
PG  - 689-93
LID - 10.1007/s00383-008-2132-x [doi]
AB  - It is controversial as to whether osteotomy, by restoring a more normal pelvic 
      anatomy, might improve the final outcome of bladder exstrophy (BE) repairs. We 
      compared the functional orthopaedic and urological outcomes in BE patients 
      treated with and without osteotomy. Orthopaedic and urological outcomes were 
      compared in eight BE patients treated with osteotomy and six BE patients treated 
      without osteotomy. Orthopaedic evaluation included an assessment of pubic bones 
      dissymmetry, bending of the spine, presence of Trendelenburg or Thomas sign, and 
      presence of out-toeing. Pubic diastasis was ruled out on a plain X-ray of the 
      pelvis. A Pediatric Orthopedic Society of North America (POSNA) questionnaire was 
      administered to every child or his/her caregiver to assess functional outcome. 
      Urological evaluation included an assessment of required continence surgeries and 
      of contemporary continence status. All patients presented a pubic diastasis. This 
      was in median 49 (24-66) mm in patients treated without osteotomy and 42 (25-101) 
      mm in those treated with osteotomy (p = 0.3). There was no difference either in 
      the orthopaedic outcome or in any features of the POSNA questionnaire between 
      groups. Neither was there a difference in the final continence rate nor in the 
      number of additional continence procedures required. Although osteotomy is an 
      essential step in the treatment of many BE patients in order to achieve a 
      tension-free closure of the abdominal wall and bladder, our preliminary results 
      suggest that it does not improve the eventual orthopaedic or urological outcomes 
      of BE.
FAU - Castagnetti, Marco
AU  - Castagnetti M
AD  - Section of Paediatric Urology, Urology Unit, Department of Oncological and 
      Surgical Sciences, University Hospital of Padova, Monoblocco Ospedaliero, Via 
      Giustiniani, 2, 35100, Padua, Italy. marcocastagnetti@hotmail.com
FAU - Gigante, Cosimo
AU  - Gigante C
FAU - Perrone, Giorgio
AU  - Perrone G
FAU - Rigamonti, Waifro
AU  - Rigamonti W
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20080403
PL  - Germany
TA  - Pediatr Surg Int
JT  - Pediatric surgery international
JID - 8609169
SB  - IM
MH  - Abdominal Wall/surgery
MH  - Adolescent
MH  - Bladder Exstrophy/*surgery
MH  - Case-Control Studies
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Humans
MH  - Male
MH  - *Osteotomy
MH  - Treatment Outcome
EDAT- 2008/04/04 09:00
MHDA- 2008/12/17 09:00
CRDT- 2008/04/04 09:00
PHST- 2008/02/27 00:00 [accepted]
PHST- 2008/04/04 09:00 [pubmed]
PHST- 2008/12/17 09:00 [medline]
PHST- 2008/04/04 09:00 [entrez]
AID - 10.1007/s00383-008-2132-x [doi]
PST - ppublish
SO  - Pediatr Surg Int. 2008 Jun;24(6):689-93. doi: 10.1007/s00383-008-2132-x. Epub 
      2008 Apr 3.