Safety and efficacy of spica casts for immobilization following initial bladder closure in classic bladder exstrophy

Angela M Arlen; Christopher S Cooper; Jose Morcuende; J Christopher Austin

doi:10.1016/j.jpurol.2010.06.005

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Safety and efficacy of spica casts for immobilization following initial bladder closure in classic bladder exstrophy

Journal article

Peer reviewed

Safety and efficacy of spica casts for immobilization following initial bladder closure in classic bladder exstrophy

Angela M Arlen, Christopher S Cooper, Jose Morcuende and J Christopher Austin

Journal of pediatric urology, Vol.7(4), pp.456-459

08/2011

DOI: 10.1016/j.jpurol.2010.06.005

PMID: 20637699

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Abstract

Pelvic immobilization constitutes a necessary component of successful bladder exstrophy closure. The efficacy of spica cast immobilization has been reported as markedly inferior to external fixation, with success rates below 25%. We reviewed our experience with spica cast immobilization following bladder closure. We retrospectively reviewed classic bladder exstrophy patients undergoing bladder closure with spica cast immobilization. Success of bladder closure and complications related to immobilization were noted, as were age, type of closure, use of osteotomy, duration of immobilization, and number of cast changes. Fifteen patients underwent bladder closure (10 staged, 5 complete repair) at a median age of 4 days (range 1-6) and 14 were immobilized with spica casts. Initial closures were successful in 11 (73%). Success rates were higher in patients undergoing osteotomies (6/7, 86%) compared to those without osteotomies (5/8, 63%). No patients immobilized with spica casts developed serious complications related to their immobilization. Minor skin breakdown occurred in 3/14 patients (21%). Median time of immobilization was 39 days (range 22-48). Spica casts are a safe, effective method of postoperative immobilization and are associated with a low risk of cast-related complications.

Casts, Surgical - adverse effects

Osteotomy

Humans

Postoperative Complications - prevention & control

Male

Treatment Outcome

Ureteral Obstruction

Restraint, Physical - methods

Restraint, Physical - adverse effects

Female

Hydronephrosis - congenital

Multicystic Dysplastic Kidney

Retrospective Studies

Bladder Exstrophy - surgery

Infant, Newborn

Details

Title: Subtitle: Safety and efficacy of spica casts for immobilization following initial bladder closure in classic bladder exstrophy
Creators: Angela M Arlen - Department of Urology, University of Iowa, Iowa City, IA, USA
Christopher S Cooper
Jose Morcuende
J Christopher Austin
Resource Type: Journal article
Publication Details: Journal of pediatric urology, Vol.7(4), pp.456-459
Publisher: England
DOI: 10.1016/j.jpurol.2010.06.005
PMID: 20637699
ISSN: 1477-5131
eISSN: 1873-4898
Language: English
Date published: 08/2011
Academic Unit: Stead Family Department of Pediatrics; Orthopedics and Rehabilitation; Urology; Medicine Administration
Record Identifier: 9984040312102771

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