Promm, Martin and Hofbauer, Raphael and Brandl, Roland and Gossler, Christopher and Brandstetter, Susanne and Kertai, Michael and Hofmann, Aybike and Schnabel, Marco J. and Roesch, Wolfgang H. (2025) Long-Term Orthopaedic and Radiological Outcomes of Symphysis Approximation without Osteotomy in Primary Bladder Exstrophy Repair. EUROPEAN JOURNAL OF PEDIATRIC SURGERY, 35 (03). pp. 195-200. ISSN 0939-7248, 1439-359X
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Introduction Previous assumptions suggested that the technique of approximation without osteotomy in primary exstrophy repair (PER) could only be applied in newborns and anticipated poorer outcomes. Recent studies indicated that this technique can be successfully executed not only in immediate PER but also yields favorable long-term results. Therefore, we evaluated and compared the orthopaedic and radiological long-term outcomes after pubic symphysis approximation without osteotomy in immediate and delayed PER. Methods From March 2018 to December 2020, individuals with PER and approximation of the symphysis without osteotomy were recruited. Patients <12 years and with a history of orthopaedic surgery of the bony pelvis were excluded. Orthopaedic examinations and magnetic resonance imaging (MRI) of the bony pelvis including the hip joints were performed and pubic diastasis, the acetabulum angle (ACA), and the center-edge angle (CEA) were evaluated. Results Twenty-nine patients were included, 11 of them had an immediate and 18 had a delayed PER. Between the two groups, no significant differences could be observed concerning hip pain ( p = 0.419), mobility impairment ( p = 0.543), sports impairment ( p = 0.543), hip impingement ( p = 1.000), leg length discrepancy ( p = 0.505), and width of the pubic diastasis as measured by MRI ( p = 0.401). There were also no significant differences with regard to CEA right (median 30 degrees, p = 0.976), CEA left (median 31.5 degrees, p = 0.420), ACA right (median 19 degrees, p = 0.382), and ACA left (median 17 degrees, p = 0.880). Conclusion There were no significant differences in clinical orthopaedic or radiological long-term outcomes between bladder exstrophy patients after immediate and delayed bladder closure with symphysis approximation without osteotomy. Establishing core outcome sets is essential to get robust and comparable results, further advancing and substantiating our initial insights.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | HIP; VALUES; EPISPADIAS; DYSPLASIA; long-term outcome; symphysis; classic bladder exstrophy |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Kinder- und Jugendmedizin Medicine > Lehrstuhl für Urologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 10 Mar 2026 06:49 |
| Last Modified: | 10 Mar 2026 06:49 |
| URI: | https://pred.uni-regensburg.de/id/eprint/63725 |
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