Van Med J. 2006; 13(1): 16-18

Exstrophy Vesica: Postoperative Two Giant Stone Developments

Yüksel Yılmaz¹, Kadir Ceylan², Haşmet Bayraklı³, Alpaslan Kuş^2
1YYU Tıp Fak Araştırma Hastanesi VAN
²YYU Tıp Fak Araştırma Hastanesi VAN
³YYU Tıp Fak Araştırma Hastanesi VAN

Extrophy vesicale is a very uncommon congenital anomaly. The urinary bladder must be closed at the very early period. In 2 of 5 cases operated due to extrophy-epispadias complex developed multiple giant stones. We present these cases to contribute to the literature. Case-1: The 3 days old case had iliac osteotomy, symphysispubis approximation and primary closure of the bladder. At the end of the 4 years waiting period for the development of bladder capacity a 4x3x1.5 cm sized stone was detected in the bladder neck. The stone was formed on the curl of the steel wire which is used to obtain proximity of the symphysis pubis, due to the contact and incrustment of urine leaked from the epispadic urethra. The wire and accompanying stone were withdrawn together. Case-2: The 18-years old patient that holds in the animal shelter by his family had total cystectomy and Indiana Pauch operation. Cosmetically good result was obtained by connection of tip of ileal conduit to the prostatic urethra. Due to the lack of follow up for six years duration, the patient was reoperated for multiple stones including one 8x6x4 cm and one 6x5x3 cm sized. Discussion and conclusion: The stone development should be expected in the reservoirs in which urine can not be emptied adequately. Thus, early diagnosis of stone development proves early treatment chance by any lithotripsy procedure. The risk of incrustation can be obviated by to not contact with the urine of foreign materials used in the reconstructive surgery.

Keywords: Exstrophy vesical, complication, stone

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Ekstrofi Vezika: Postoperatif 2 Dev Taş Olgusu

Yüksel Yılmaz¹, Kadir Ceylan², Haşmet Bayraklı³, Alpaslan Kuş^2
1Yüzüncü Yıl Üniversitesi Tıp Fakültesi Üroloji AD, Van
²Yüzüncü Yıl Üniversitesi Tıp Fakültesi Üroloji Anabilim Dalı, Van
³YYU Tıp Fak Araştırma Hastanesi, VAN

Ekstrofi vezikal seyrek bir konjenital anomalidir. En erken dönemde düzeltilmelidir. Ekstrofi epispadias kompleksi olan 5 olgudan komplikasyon gelişen 2 olguyu sunuyoruz. Olgu 1: 3 günlük iken iliak osteotomi ve primer mesane kapatması uygulanan hastada 4 yıl sonra simfiz pubis yaklaştırılmasında kullanılan serklaj telinin enkrustasyonuna bağlı 4x3x1.5 cm çaplı taş oluşumu. Olgu 2: 18 yaşına kadar tedavi edilmemiş ekstrofi-epispadias kompleksi olan bir hasta; total sistektomi ve Indiana Pauch uygulanması sonrasında 6. yılda poş içinde 5-6 adet dev taş oluşumu ile geldi. Sonuç: Literatüre katkı olması amacıyla sunuldu

Anahtar Kelimeler: Ekstrofi vezikal, komplikasyon, taş

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