{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:02:53Z","timestamp":1787169773929,"version":"build-2736575974"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,1]]},"abstract":"\n Introduction:<\/jats:title>\n Bladder exstrophy is an anomaly, which if not treated early in the age, poses a surgical challenge in providing an adequate abdominal wall closure. We report our experience in patients with untreated exstrophy of the bladder, who underwent cystectomy, ileal conduit, and abdominal reconstruction using the anterior rectus sheath turndown flap and paired inguinal skin flaps.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n Ten previously unoperated adult patients with exstrophy with epispadias, who underwent surgery at our institute from January 2010 till January 2021, were included in this study to evaluate the adequacy of abdominal wall closure with our technique of retrograde turndown anterior rectus sheath flap with paired inguinal flap, and to document immediate and delayed complications, especially incisional hernia.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n The mean follow-up period of the study was 16.5 months. We found that our technique provided adequate local tissue for a sturdy two-layered closure of the lower abdominal wall defect. Out of the ten patients, only one required an additional flap for abdominal wound closure. There were no stoma-related complications or incisional hernia.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Abdominal wall reconstruction, for skin and fascial defects, in such complex cases can be performed by local skin and fascia using a relatively simple, safe, easy, and affordable technique as we have described. Our technique avoids the use of synthetic mesh, thereby reducing the chances of infection in such chronic open wounds.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/iju.iju_204_21","type":"journal-article","created":{"date-parts":[[2023,8,12]],"date-time":"2023-08-12T06:03:27Z","timestamp":1691820207000},"page":"48-52","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Abdominal wall closure in adult patients with untreated exstrophy of bladder"],"prefix":"10.4103","volume":"38","author":[{"given":"Ashish Kumar","family":"Gupta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amish Jayantilal","family":"Gohil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shashank","family":"Lamba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R2-9-20240903","doi-asserted-by":"crossref","first-page":"43","DOI":"10.4103\/0971-9261.78128","article-title":"The management of bladder exstrophy: Indian scenario","volume":"16","author":"Bhatnagar","year":"2011","journal-title":"J Indian Assoc Pediatr Surg"},{"key":"R3-9-20240903","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1016\/j.urology.2014.06.063","article-title":"Exstrophy-epispadias complex presenting in adulthood: A single-center review of presentation, management, and outcomes","volume":"84","author":"Venkatramani","year":"2014","journal-title":"Urology"},{"key":"R4-9-20240903","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1097\/00006534-195903000-00006","article-title":"Plastic repair of congenital defects of the ventral body wall with particular reference to exstrophy of the bladder","volume":"23","author":"Longacre","year":"1959","journal-title":"Plast Reconstr Surg Transplant Bull"},{"key":"R5-9-20240903","doi-asserted-by":"crossref","first-page":"243","DOI":"10.4103\/1596-3519.84704","article-title":"Abdominal wall closure in bladder exstrophy complex repair by rectus flap","volume":"10","author":"Hosseini","year":"2011","journal-title":"Ann Afr Med"},{"key":"R6-9-20240903","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1007\/s00345-009-0436-7","article-title":"Management of bladder exstrophy epispadias complex in adults: Is abdominal closure possible without osteotomy?","volume":"28","author":"Mansour","year":"2010","journal-title":"World J Urol"},{"key":"R7-9-20240903","doi-asserted-by":"crossref","first-page":"164","DOI":"10.4103\/0970-1591.40609","article-title":"Bladder exstrophy in adulthood","volume":"24","author":"Nerli","year":"2008","journal-title":"Indian J Urol"},{"key":"R8-9-20240903","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/S0094-1298(20)31415-2","article-title":"Use of the rectus abdominis muscle and fascia flap in reconstruction of epispadias\/exstrophy","volume":"15","author":"Horton","year":"1988","journal-title":"Clin Plast Surg"},{"key":"R9-9-20240903","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1007\/s10029-015-1414-1","article-title":"Abdominal wall dysfunction in adult bladder exstrophy: A treatable but under-recognized problem","volume":"20","author":"Manahan","year":"2016","journal-title":"Hernia"},{"key":"R10-9-20240903","first-page":"84","article-title":"Abdominal Wall Reconstruction with Polyprolene-mesh (PROLENETM) in Exstrophy of Bladder - An Interim Report","volume":"27","author":"Ragavan","year":"2014","journal-title":"JIMSA"},{"key":"R11-9-20240903","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1097\/00006534-199606000-00028","article-title":"Use of the expanded thoracoepigastric myocutaneous flap in the closure of cloacal exstrophy","volume":"97","author":"Schaeffer","year":"1996","journal-title":"Plast Reconstr Surg"},{"key":"R13-9-20240903","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/j.jpurol.2012.06.004","article-title":"Management of bladder exstrophy in adulthood: Report of 5 cases","volume":"9","author":"Shoukry","year":"2013","journal-title":"J Pediatr Urol"},{"key":"R14-9-20240903","article-title":"Management of cavernous abdominal wall defects post radical cystectomy in adult exstrophy complex","volume":"12","author":"Kumar","year":"2019","journal-title":"BMJ Case Rep"},{"key":"R15-9-20240903","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1016\/j.surg.2010.01.008","article-title":"Incisional ventral hernias: Review of the literature and recommendations regarding the grading and technique of repair","volume":"148","author":"Breuing","year":"2010","journal-title":"Surgery"},{"key":"R16-9-20240903","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1016\/S0090-4295(01)00959-1","article-title":"Bladder preservation in adult classic exstrophy: Early results of four patients","volume":"57","author":"Pathak","year":"2001","journal-title":"Urology"},{"key":"R17-9-20240903","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/s13017-018-0200-7","article-title":"The long-term outcomes of early abdominal wall reconstruction by bilateral anterior rectus abdominis sheath turnover flap method in critically ill patients requiring open abdomen","volume":"13","author":"Arai","year":"2018","journal-title":"World J Emerg Surg"}],"container-title":["Indian Journal of Urology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/iju.iju_204_21","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:13:09Z","timestamp":1787166789000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/iju.iju_204_21"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1]]},"references-count":15,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.4103\/iju.iju_204_21","relation":{},"ISSN":["0970-1591"],"issn-type":[{"value":"0970-1591","type":"print"}],"subject":[],"published":{"date-parts":[[2022,1]]}}}