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№1’2025, part 2
Topic of the issue:

Covered exstrophy of the bladder, approaches to treatment

№1’2025, part 1
Topic of the issue:

Replacement of long ureteral strictures in children

№1’2025, part 2- page. 191-198

Covered exstrophy of the bladder, approaches to treatment

DOI: 10.29188/2222-8543-2025-18-1-191-198
For citation:

Lagutin G.V., Rudin Yu.E., Chekeridi E.Yu., Aliyev D.K., Vardak A.B., Rudin A.Yu., Polyakov N.V., Apolikhin O.I., Kaprin A.D. Covered exstrophy of the bladder, approaches to treatment. Experimental and Clinical Urology 2025;18(1):191-198; https://doi.org/10.29188/2222-8543-2025-18-1-191-198

Lagutin G.V., Rudin Yu.E., Chekeridi E.Yu., Aliev D.K., Vardak A.B., Rudin A.Yu., Polyakov N.V., Apolikhin O.I., Kaprin A.D.
Information about authors:
  • Lagutin G.V. – PhD, doctor of children's uroandrology Department of N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – Branch of the National Medical Research Centre of Radiology of the Ministry of Health of Russian Federation; Moscow, Russia; RSCI Author ID 1003158, https://orcid.org/0000-0003-3162-5997
  • Rudin Yu.E. – Dr. Sci., professor, head of the group of pediatric urology of N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – branch of the National Medical Research Radiological Center of the Ministry of Health of Russian Federation; Mosсow, Russia; RSCI Author ID 423343, https://orcid.org/0000-0001-5973-615X
  • Chekeridi Yu.E. – PhD, deputy chief physician at the medical unit of Moscow Regional Children's trauma and orthopedic hospitals; Mosсow, Russia
  • Aliev D.K. – PhD, doctor of children's uroandrology Department of N. Lopatkin Scien- tific Research Institute of Urology and Interventional Radiology – branch of the National Medical Research Radiological Center of the Ministry of Health of Russian Federation; Mosсow, Russia; RSCI Author ID 1003160, https://orcid.org/0000-0002-9813-3447
  • Vardak A.B. – PhD, doctor of children's uroandrology Department оf N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – branch of the National Medical Research Radiological Center of the Ministry of Health of Russian Federation, Mosсow, Russia; RSCI Author ID 695565, https://orcid.org/0000-0003-0722-4237
  • Rudin A.Yu. – pediatric urologist, Childrens Hospital st. Vladimir; Moscow, Russia; RSCI Author ID 1090178, https://orcid.org/0000-0002-8098-6441
  • Polyakov N.V. – PhD, Head of the Reconstructive Urology Group of the Department of General and Reconstructive Urοlοgy of N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – branch of the National Medical Research Radiological Center of the Ministry of Health of Russian Federation; Moscow, Russia; RSCI Author ID 412267
  • Apolikhin O.I. – Dr. Sci., professor, сor.-member of RAS, director of N. Lopatkin Scientific Research Institute of urology and Interventional Radiology – branch of the National Medical Research Centre of Radiology of Ministry of health of Russian Federation; Moscow, Russia; RSCI Author ID 683661, https://orcid.org/0000-0003-0206-043X
  • Kaprin A.D. – Dr. Sci., professor, academician of RAS, general director of the National Medical Research Centre of Radiology of Ministry of health of Russian Federation, director of P.A. Herzen Institution, Head of Department of Oncology and Radiology named after V.P. Kharchenko of RUDN University; Moscow, Russia; RSCI Author ID 96775, https://orcid.org/0000-0001-8784-8415
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Introduction. Classic bladder exstrophy is a rare anomaly, occurring in a ratio of 1:30000 to 1:50000 newborns. However, various variants of the exstrophy-epispadias complex are 10 times less common. Covered bladder exstrophy is a rare variant of classic exstrophy. Patients with the covered variant of exstrophy can be considered as classic exstrophy with all the accompanying defects of this anomaly, but with a bladder that is closed and covered only by a thin, often translucent skin membrane without muscles or a fascial layer. Cases in this category of patients may be underestimated in terms of the size of the defect at initial detection.

Case report. The article describes two rare clinical observations of treatment of children with covered bladder exstrophy. A 5-year-old boy underwent a full range of surgical treatment: primary closure of the bladder, Cohen ureterocystoneoimplantation, bladder neck plastic surgery, bilateral iliac osteotomy, with reduction and fixation of the pubic bones. A 10-year-old girl underwent plastic surgery of the anterior abdominal wall, bilateral iliac osteotomy, and reduction (convergence) of the pubic bones.

Conclusions. It is important to follow the principles of classical exstrophy correction in the treatment of children with covered bladder exstrophy. In the presence of symptoms of urinary incontinence, bladder neck reconstruction is indicated, this will improve continence and promote adequate bladder growth. Correct treatment of these malformations of the genitourinary system can significantly improve the quality of life of these patients.

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Keywords: bladder exstrophy; covered exstrophy of the bladder; exstrophy-epispadias complex; children; surgical treatment