Complete primary repair of adult bladder exstrophy-epispadias complex without iliac osteotomy: a case report and literature review

Abstract

Bladder exstrophy-epispadias complex is a rare anomaly of the genitourinary system. Adult presentation is uncommon because most patients would have completed their treatment in early childhood. We report a 32-year-old man with classic bladder exstrophy who underwent complete primary repair with no iliac osteotomy to highlight the possibility of complete repair of adult bladder exstrophy without performing an iliac osteotomy despite a wide pubic symphyseal diastasis. The patient presented with a lower abdominal wall defect and an abnormal penis since birth. On examination, he had a lower abdominal wall defect, exposing the bladder plate with a flat and spade-like phallus. Pelvic X-ray showed a wide pubic symphyseal diastasis. He underwent complete repair of exstrophy without an iliac osteotomy. Horizontally oriented double V-Y flaps were raised to cover the abdominal wall defect.