ONE-STAGE DELAYED BLADDER EXSTROPHY CLOSURE COMBINED WITH KELLY REPAIR: Early outcomes following the 100-case milestone
PURPOSE: To evaluate bladder dehiscence after one-stage delayed closure of bladder/cloacal exstrophy combining bladder plate closure with Kelly procedure, with or without osteotomy. MATERIALS AND METHODS: Multicenter retrospective study of children with bladder exstrophy or cloacal exstrophy who underwent single-stage closure with Kelly mobilization (October 2015-October 2025), by one surgical team, in France and tertiary centers abroad. The primary endpoint was bladder dehiscence within 3 months. Secondary endpoints were early (<3 months) complications. Outcomes were analyzed separately for primary repairs and complex cases. RESULTS AND CONCLUSION: muscles midline transposition was the only independent prognostic factor of wound complications (OR 4.47 [1.22-16.37] p= .02).Single-stage delayed closure combined with Kelly mobilization allows reliable bladder closure with no early dehiscence in bladder/cloacal exstrophy. Early morbidity rate was <20%, with predominantly low-grade complications. When pubic approximation was difficult, osteotomies or fascial flaps appeared to offer better early parietal outcomes than rectus muscles transposition.
Authors
- Olivier Abbo (ORCID: https://orcid.org/0000-0002-4202-4284)
- Luke Harper (ORCID: https://orcid.org/0000-0002-3421-351X)
- Nicolas Kalfa (ORCID: https://orcid.org/0000-0001-5472-4096)
- Alice Faure (ORCID: https://orcid.org/0000-0002-3327-6391)
- R. Moog
- A el Ghoneimi
- Hortense Alliot (ORCID: https://orcid.org/0000-0002-8009-4611)
- Alfredo Berrettini (ORCID: https://orcid.org/0000-0001-6779-0762)
- D. Demède (ORCID: https://orcid.org/0000-0003-4770-8535)
- Marc‐David Leclair (ORCID: https://orcid.org/0000-0002-1771-9025)
- Xavier Delforge (ORCID: https://orcid.org/0000-0002-6149-883X)
- T. Loubersac (ORCID: https://orcid.org/0000-0001-6658-2048)
- Thomas Blanc (ORCID: https://orcid.org/0000-0002-5829-8167)
- Sajid Sultan
- Pedro-Jose Lopez
- Jovelinho LEAO
Institutions
- Hôpital Necker-Enfants Malades (FR)
- Sindh Institute of Urology and Transplantation (PK)
- Centre Hospitalier Universitaire de Nantes (FR)
- Centre Hospitalier Universitaire de Toulouse (FR)
- Ospedale Maggiore (IT)
- Centre Hospitalier Universitaire Amiens-Picardie (FR)
- Hospices Civils de Lyon (FR)
- Laboratoire National de Référence (MA)
- Hôpital Pellegrin (FR)
- Production Development Corporation (CL)
- Hôpital Robert-Debré (FR)
- Hospital Materno-Infantil (ES)
- Hôpital Lapeyronie (FR)
- Hôpital des Enfants (FR)
- Hôpital de la Timone (FR)
- Nantes Université (FR)
Publication Details
- Journal
- The Journal of Urology
- Published
- 2026-06-12
- DOI
- https://doi.org/10.1097/ju.0000000000005167
- Primary Topic
- Gallbladder and Bile Duct Disorders
- Type
- article
- Field-Weighted Citation Impact
- 0.00