Multi-Layer Reconstruction of Cloacal Bladder Exstrophy with a Pedicled Anterior Lateral Thigh Perforator Flap, Vastus Lateralis Muscle and Fascia Lata

Introduction

Cloacal bladder exstrophy is a rare congenital genitourinary malformation that occurs with varying degrees of severity. It is associated with epispadias and can be accompanied by lack of the urinary sphincter, clitoris duplex, diastasis of the rectus muscles and pelvic diastasis. Despite early surgical repair, debilitating long-term problems including urinary incontinence and abdominal wall deficiency can occur. Restoration of the structural integrity of the pediatric abdominal wall can represent a significant reconstructive challenge and has been attempted using a variety of approaches including primary closure, skin grafts, allogenic and xenogenic substitutes, and flap transfer. Here, we report a case of cloacal bladder exstrophy in which multi-layer reconstruction of an abdominal wall defect with a pedicled anterior lateral thigh perforator flap, vastus lateralis muscle and fascia lata was performed.

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