{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T06:10:04Z","timestamp":1756275004276,"version":"3.44.0"},"reference-count":5,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2018,12,7]]},"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:p>The exstrophy\u2013epispadias complex represents a spectrum of genitourinary malformations ranging from simple glanular epispadias to an overwhelming multisystem defect, cloacal exstrophy. Neonatal total reconstruction of bladder exstrophy\u2013epispadias complex is the treatment of choice. An adult patient presenting with untreated exstrophy is very rare. Malignant transformation, commonly adenocarcinoma, in such cases is a known complication due to mucosal metaplasia of urothelium. Management in such cases necessitates a radical surgical procedure that often results in a massive defect in the anterior abdominal wall. Providing a cover for such defects is a challenging task for the reconstructive surgeon. Local skin flaps and wide mobilisation of the rectus muscle are the usually employed techniques for closure of such defects. However, these may be inadequate in extremely large defects such as those encountered in our patients. We, hereby, describe our technique of closure of the abdominal wall defect using a pedicled anterolateral thigh flap.<\/jats:p>","DOI":"10.1136\/bcr-2018-226076","type":"journal-article","created":{"date-parts":[[2019,1,14]],"date-time":"2019-01-14T12:55:40Z","timestamp":1547470540000},"page":"bcr-2018-226076","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Management of cavernous abdominal wall defects post radical cystectomy in adult exstrophy complex"],"prefix":"10.1136","volume":"12","author":[{"given":"Prashant","family":"Kumar","sequence":"first","affiliation":[{"name":"Urology, AIIMS, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rishi","family":"Nayyar","sequence":"additional","affiliation":[{"name":"Urology, AIIMS, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amlesh","family":"Seth","sequence":"additional","affiliation":[{"name":"Urology, AIIMS, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepti","family":"Gupta","sequence":"additional","affiliation":[{"name":"Plastic Reconstructive and Burns Surgery, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,1,14]]},"reference":[{"key":"2025082622400102000_12.1.bcr-2018-226076.1","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.fjs.2013.07.004","article-title":"Surgical safety margin of gastroenterological cancer surgery: A truth or a dream?","volume":"47","author":"Chen-GuoKer","year":"2014","journal-title":"Formosan J Surg"},{"key":"2025082622400102000_12.1.bcr-2018-226076.2","doi-asserted-by":"crossref","first-page":"2194","DOI":"10.3892\/etm.2015.2793","article-title":"Bladder exstrophy-epispadias complex with adenocarcinoma in an adult patient: A case report","volume":"10","author":"Xiong","year":"2015","journal-title":"Exp Ther Med"},{"key":"2025082622400102000_12.1.bcr-2018-226076.3","doi-asserted-by":"crossref","first-page":"S36","DOI":"10.1186\/1471-2482-13-S2-S36","article-title":"Presenting a case of a mucinous adenocarcinoma of an exstrophic bladder in an adult patient and a review of literature","volume":"13","author":"Di Lauro","year":"2013","journal-title":"BMC Surg"},{"key":"2025082622400102000_12.1.bcr-2018-226076.4","first-page":"PD17","article-title":"A rare case of an adult with untreated bladder exstrophy presenting with signet-ring cell adenocarcinoma of urinary bladder","volume":"10","author":"Savalia","year":"2016","journal-title":"J Clin Diagn Res"},{"key":"2025082622400102000_12.1.bcr-2018-226076.5","doi-asserted-by":"crossref","first-page":"142","DOI":"10.4103\/0970-1591.152920","article-title":"Primary squamous cell carcinoma of bladder exstrophy in an adult","volume":"31","author":"Bhat","year":"2015","journal-title":"Indian J Urol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-226076","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T05:40:08Z","timestamp":1756273208000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-226076"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1]]},"references-count":5,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,1,14]]},"published-print":{"date-parts":[[2019,1]]}},"alternative-id":["10.1136\/bcr-2018-226076"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-226076","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2019,1]]}}}