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Wire in the hole: a case series of eroded intrapubic wire sutures causing genitourinary complications in the bladder exstrophy complex

Joan S. Ko, Angela D. Gupta, Heather N. Di Carlo, Kathy Lue, John P. Gearhart

Department of Urology, The James Buchanan Brady Urological Institute, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
Address correspondence to Dr. Joan S. Ko, Department of Urology, The James Buchanan Brady Urological Institute, The Johns Hopkins School of Medicine, 1800 Orleans Street, Baltimore, MD 21287 USA

Canadian Journal of Urology 2016, 23(5), 8476-8479.

Abstract

Bladder exstrophy and cloacal exstrophy are rare congenital defects of the genitourinary tract that require complex surgical reconstruction. Malrotation of the bony pelvis causes a characteristic diastasis of the pubic symphysis, which is surgically reduced at the time of initial bladder closure. For a successful primary closure without tension such that the bladder can be placed deep within the pelvis, pelvic osteotomy is often used. However, alternative techniques have been utilized to bring the pubic rami into apposition. The authors present four bladder/ cloacal exstrophy patients in which an intrapubic wire was used for pubic apposition, resulting in significant genitourinary complications.

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