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Springer The Exstrophy—Epispadias Complex Research Concepts and Clinical Applications 1st Editon 2010 Softbound by John P. Gearhart, Ranjiv Mathews
The undertaking of the treatment of an infant born with bladder exstrophy is one of the most weighty responsibilities that can fall upon the shoulders of the reconstructive sur geon. The modern treatment of a child born with bladder exstrophy began in the mid- 1970's with the widespread application of staged reconstruction. This approach has consistently yielded very good results in several series. However, as in all serious congeni tal birth defects, there is certainly room for advancement. Issues such as the routine use of osteotomy, timing and type of epispadias repair, combining bladder closure with epispadias repair, the approach to the small bladder, and the management of a failed exstrophy still remain. This National Institute of Health/Na tional Kidney Foundation/Johns Hopkins-sponsored seminar was an attempt to bring ex perts in the field of pediatric orthopedic surgery, pediatric urology, pediatric surgery, adult urology, and basic science together to share their experiences in an attempt to foster new clinical and basic science research communications between the participants. If these col laborations result, then this first international meeting will have been successful. The editors would like to thank all of the contributors for their timely and complete submissions. John P. Gearhart, M.D. Ranjiv Mathews, M.D. vii CONTENTS 1. The Embryology and Epidemiology of Bladder Exstrophy ................. . 1. The Embryology and Epidemiology of Bladder Exstrophy.- 2. Prenatal Diagnosis of Bladder and Cloacal Exstrophy and Related Conditions.- 3. Anatomy and Biomechanics of the Pelvis in Exstrophy.- 4. Detrusor Morphology and Innervation in Bladder Exstrophy: A Preliminary Investigation.- 5. The Response of the Bladder Smooth Muscle to Increased Bladder Neck Resistance.- 6. Muscarinic Cholinergic Receptors in Bladder Exstrophy: Pharmacological Observations Supporting Functional Closure and Subsequent Bladder Neck Reconstruction.- 7. A Quantitative Histological Analysis of the Bladder in Classical Bladder Exstrophy in Various Stages of Reconstruction Utilizing Color Morphometry.- 8. Analysis of Smooth Muscle and Collagen Subtypes in the Normal Newborn and Bladder Exstrophy Patient.- 9. A Large Animal Model of Bladder Exstrophy: Observations on Bladder Smooth Muscle and Collagen Content and Function.- 10. Tissue Engineering Techniques For Closure of Bladder Exstrophy: An Experimental Animal Model.- 11. Surgical Principles in the Primary Closure of Bladder Exstrophy.- 12. Anterior and Posterior Innominate Osteotomy in Exstrophy Repair.- 13. Bladder Exstrophy Closure without Osteotomy in Philadelphia.- 14. Bilateral Anterior Pubic Osteotomy in Bladder Exstrophy Closure.- 15. The Failed Exstrophy Closure: Strategies for Management—the Johns Hopkins Experience.- 16. Applications of Ureterosigmoidostomy in Bladder Exstrophy.- 17. Cystoplasty in Bladder Exstrophy: Indications and Techniques.- 18. Bladder Exstrophy: Therapeutic Alternatives.- 19. Penile Length in Adulthood after Exstrophy Reconstruction.- 20. Complete Penile Disassembly for Epispadias Repair.- 21. The Cantwell-Ransley Epispadias Repair in Exstrophy/Epispadias: Lessons Learned.- 22. The Impact of Urodynamics on Surgery for Incontinence in Children with Exstrophy.- 23. The Use of Sub-Mucosal Collagen in the Small Bladder Associated with Bladder Exstrophy.- 24. Review of Long-Term Results of Staged Functional Reconstruction and Bladder Neck Plasty in Bladder Exstrophy Patients Followed from Birth at the Johns Hopkins Hospital.- 25. Psychological Aspects of Bladder Exstrophy: Vulnerabilities, Risks, and Protective Factors from a Longitudinal Perspective.- 26. The Outcome of Patients with Classic Bladder Exstrophy in Adult Life.- 27. Long Term Results of Bladder Exstrophy: The London Experience.- 28. Long Term Results of Bladder Exstrophy: The Mainz Experience.- 29. Semen Analysis and Transrectal Ultrasound Findings in Men with Bladder Exstrophy.- 30. Anatomy of Cloacal Exstrophy: The Surgical Implications.- 31. Current Urologic Management of Cloacal Exstrophy: Experience with 11 Patients.- 32. Indications and Types of Bladder Augmentation in Cloacal Exstrophy.- 33. Cloacal Exstrophy: Experience with 41 Cases from 1976–1997.