Failed bladder exstrophy repair: Evaluation and management

Early successful closure, careful management of the incontinent interval, and a good technical bladder neck reconstruction can result in a patient with normal control and upper tracts. However, failure at any step of a staged functional reconstruction does not doom a child to failure in the eventual achievement of these goals. Nonetheless, taking care of the exstrophy failure is still a formidable task for the reconstructive surgeon. Careful evaluation of the failure, waiting an appropriate interval before further reconstructive surgery is attempted, and dedication to the patient most often can produce a successful result.