{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T22:40:23Z","timestamp":1792017623165,"version":"4.4.0"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Bladder exstrophy (BE) is a rare congenital anomaly. In resource-limited settings, delayed presentation is common, necessitating augmentation cystoplasty in older children with fibrotic and poorly compliant bladders. The necessity of simultaneous ureteric reimplantation (UR) during augmentation remains debated. The objective of the study is to evaluate long-term renal and urological outcomes in children undergoing complete primary repair of exstrophy (CPRE) with or without UR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective study analyzed 51 patients who underwent CPRE with augmentation between 1999 and 2019 and had a minimum follow-up of 5 years. Patients were divided into two groups: Group A (CPRE with UR) and Group B (CPRE only). Surgical details, complications, and follow-up outcomes, including Society of Fetal Urology (SFU) grades of hydronephrosis, renal function, and urinary tract infections (UTIs), were compared. Statistical analysis was performed using the Chi-square test for categorical variables and the t-test and the Mann\u2013Whitney test for continuous variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Group A had 24 patients, and Group B had 27 patients. Baseline characteristics, including age, gender distribution, serum creatinine, estimated glomerular filtration rate, and hydronephrosis, exhibited no significant differences between the two groups. No statistically significant differences were observed in rates of postoperative SFU grades of hydronephrosis, UTI, or renal function decline between the groups. While moderate-to-severe hydronephrosis was more common in Group B, this did not translate into worse clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In delayed BE repair requiring bladder augmentation, omission of UR appears safe and effective. Bladder augmentation alone provides adequate protection of the upper tracts and may simplify surgical planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/iju.iju_276_25","type":"journal-article","created":{"date-parts":[[2025,12,28]],"date-time":"2025-12-28T15:00:32Z","timestamp":1766934032000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Challenging the need for reimplantation in augmented bladders: Evidence from delayed exstrophy repair"],"prefix":"10.4103","author":[{"given":"Aaryan","family":"Anand","sequence":"first","affiliation":[{"name":"Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanchit","family":"Rustagi","sequence":"additional","affiliation":[{"name":"Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nayab","family":"Danish","sequence":"additional","affiliation":[{"name":"Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gajendrasingh","family":"Kishansingh","sequence":"additional","affiliation":[{"name":"Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish","family":"Ranjan","sequence":"additional","affiliation":[{"name":"Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anupam","family":"Shukla","sequence":"additional","affiliation":[{"name":"Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohd S.","family":"Ansari","sequence":"additional","affiliation":[{"name":"Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyank","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,12,1]]},"reference":[{"key":"R1-20260218","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1007\/s11934-008-0028-x","article-title":"The exstrophy-epispadias complex","volume":"9","author":"Eeg","year":"2008","journal-title":"Curr Urol Rep"},{"key":"R3-20260218","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1016\/S0022-5347(01)66295-5","article-title":"Vesical neck reconstruction in patients with the exstrophy-epispadias complex","volume":"155","author":"McMahon","year":"1996","journal-title":"J Urol"},{"key":"R4-20260218","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1007\/BF00874003","article-title":"Lower urinary tract function after exstrophy closure","volume":"6","author":"Hollowell","year":"1992","journal-title":"Pediatr Nephrol"},{"key":"R5-20260218","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1016\/S0022-5347(05)68327-9","article-title":"Complete primary repair of exstrophy","volume":"162","author":"Grady","year":"1999","journal-title":"J Urol"},{"key":"R6-20260218","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1016\/j.jpurol.2009.03.015","article-title":"Outcome of complete primary bladder exstrophy repair: Single-center experience","volume":"5","author":"Shoukry","year":"2009","journal-title":"J Pediatr Urol"},{"key":"R7-20260218","doi-asserted-by":"crossref","first-page":"287","DOI":"10.5213\/inj.1836174.087","article-title":"Long-term outcomes of augmentation cystoplasty in a pediatric population with refractory bladder dysfunction: A 12-year follow-up experience at single Center","volume":"22","author":"Mehmood","year":"2018","journal-title":"Int Neurourol J"},{"key":"R8-20260218","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1186\/s12894-022-00997-7","article-title":"Ureteral reimplantation during augmentation cystoplasty is not needed for vesicoureteral reflux in patients with neurogenic bladder: A long-term retrospective study","volume":"22","author":"Chiba","year":"2022","journal-title":"BMC Urol"},{"key":"R9-20260218","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/j.kjms.2016.05.003","article-title":"Augmentation enterocystoplasty without reimplantation for patients with neurogenic bladder and vesicoureteral reflux","volume":"32","author":"Zhang","year":"2016","journal-title":"Kaohsiung J Med Sci"},{"key":"R10-20260218","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1007\/BF02012459","article-title":"Ultrasound grading of hydronephrosis: Introduction to the system used by the Society for Fetal Urology","volume":"23","author":"Fernbach","year":"1993","journal-title":"Pediatr Radiol"},{"key":"R11-20260218","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/BF02388714","article-title":"International system of radiographic grading of vesicoureteric reflux. International reflux study in children","volume":"15","author":"Lebowitz","year":"1985","journal-title":"Pediatr Radiol"},{"key":"R12-20260218","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1016\/S0022-5347(05)64469-2","article-title":"Is ureteral reimplantation necessary during augmentation cystoplasty in patients with neurogenic bladder and vesicoureteral reflux?","volume":"168","author":"Simforoosh","year":"2002","journal-title":"J Urol"},{"key":"R13-20260218","doi-asserted-by":"crossref","first-page":"2259","DOI":"10.1016\/S0022-5347(05)66179-4","article-title":"Should we treat vesicoureteral reflux in patients who simultaneously undergo bladder augmentation for neuropathic bladder?","volume":"165","author":"L\u00f3pez Pereira","year":"2001","journal-title":"J Urol"},{"key":"R14-20260218","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1002\/bdr2.2056","article-title":"Bladder augmentation in exstrophy vesicae: Long-term results of a single experienced center","volume":"114","author":"Demirkan","year":"2022","journal-title":"Birth Defects Res"},{"key":"R15-20260218","doi-asserted-by":"crossref","first-page":"66.e1","DOI":"10.1016\/j.jpurol.2014.12.003","article-title":"Bladder calculi in the augmented bladder: A follow-up study of 160 children and adolescents","volume":"11","author":"Kisku","year":"2015","journal-title":"J Pediatr Urol"},{"key":"R16-20260218","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1016\/j.juro.2013.11.057","article-title":"Cutting for stone in augmented bladders-what is the risk of recurrence and is it impacted by treatment modality?","volume":"191","author":"Szymanski","year":"2014","journal-title":"J Urol"},{"key":"R17-20260218","doi-asserted-by":"crossref","first-page":"1576","DOI":"10.1002\/nau.24713","article-title":"Long-term effectiveness and safety of bladder augmentation in spina bifida patients","volume":"40","author":"Romero-Maroto","year":"2021","journal-title":"Neurourol Urodyn"}],"container-title":["Indian Journal of Urology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/iju.iju_276_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:58:51Z","timestamp":1786647531000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/iju.iju_276_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,1]]},"references-count":16,"URL":"https:\/\/doi.org\/10.4103\/iju.iju_276_25","relation":{},"ISSN":["0970-1591","1998-3824"],"issn-type":[{"value":"0970-1591","type":"print"},{"value":"1998-3824","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,1]]},"assertion":[{"value":"2025-06-22","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-01","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}