Role of bulking agents in bladder exstrophy-epispadias complexes

Background: Role of pelvic osteotomy in surgical management of bladder exstrophy is controversial But pelvic rim closure importantly. Bulking agents have been used for perineal and pelvic dysfunction in adults. In this study, bladder extrophy repair was performed without pubic closure And bulking agent injections were used as the strut of anterior pelvis for prevention of Organ prolapse and other functions in this series. Patients and Methods: During the period 2008-2012, twenty-five exstrophy-epispadias complex patients with a mean age of 14 months underwent surgical reconstruction. Rectus abdominis Muscle was detached from the superior pubis and sutured to each other in the midline and Re-anchored at the pubis and 8-9 month later urethra was constructed and placed between prineal muscles. Bladder neck repair and intersyphyseal reconstruction was done With bulking agents one year after primary bladder closure when in our series bladder Prolapse mainly occurred. One to 4 mL of bulking agents polyacrylate (vantris/promedon) was injected at the level of the intersymphyseal area and opening on either sides of the urethra. Results: Mean urinary continence score, before, 3 and 6months after injection Were (2.65 ± 074),(1.95 ± 082),(1.75 ± 0.78), respectively.(p Conclusion: Using bulking agents is a good alternative to sling pelvic floor not only cosmetically but also for ease of patients and operation.