Abdominal wall closure in bladder exstrophy complex repair by rectus flap

Background and Objectives: The Exstrophy Complex (EC) is a serious malformation of midline abdominal wall. Wide pubis prevents approximating the lateralized rectus muscle and leads to dehiscence and fistula formation. Our aim was to recommend an easier method for abdominal wall closure in the Bladder Exstrophy (BE) complex repair. Materials and Methods: From November 2007 to April 2010, we had three case of Cloacal Exstrophy (CE) and 10 BE, in which early bladder closure and coverage were performed by wide mobilization of bladder and rectus muscle flap closure in the midline without pubic closure. Results: Two cases of CE had only minor wound dehiscence and bladder prolapsed later. One of the 10 BE cases developed vesicocutaneous fistula and the other two had minor wound dehiscence. Conclusions: Our Technique reconstructed the abdominal wall with less morbidity and hospitalization because of tensionless closure.