A 6-year-old female patient diagnosed with exstrophy of the aca who underwent surgery on several occasions in different institutions. At the time of consultation, multiple fistulas and an important upper abdominal wall defect were observed.
Due to the previous failure in the creation of a bladder reservoir the reconstruction is programmed operating in team with the Pediatric Urology Service.
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1st Surgical time:
It consisted of placing two rectangular expanders of 1000cc. and 15.2cm long x 7 cm wide, with a valve position at the apoilimed® subgrade above the abdominal muscle.
Performing tolerance between 50 and 100cc of saline solution at intervals of 1 week to 20 days, according to the patient's tolerance, up to a volume of 1150cc.
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2nd Surgical time:
After the expansion was completed the extraction of expanders and reconstruction of the ileocal urinary reservoir was performed. After this, cutaneous rotation was performed, expanding the abdominal defect and folding the two axes of omentum.
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The patient was admitted favorably without complications.
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