Case Report

The short-term disadvantageous of tension-suture and spica cast application in exstrophy-epispadias complex reconstruction: a case report

Ida Bagus Putra Pramana , Anak Agung Gde Oka, Gede Wirya Kusuma Duarsa, Kadek Budi Santosa, I Wayan Yudiana, Pande Made Wisnu Tirtayasa

Ida Bagus Putra Pramana
Urology Surgeon, Faculty of Medicine, Universitas Udayana, Universitas Udayana General Hospital, Bali Indonesia. Email: bagusputra@unud.ac.id

Anak Agung Gde Oka
Department of Urology Surgery, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia

Gede Wirya Kusuma Duarsa
Department of Urology Surgery, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia

Kadek Budi Santosa
Department of Urology Surgery, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia

I Wayan Yudiana
Department of Urology Surgery, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia

Pande Made Wisnu Tirtayasa
Department of Urology Surgery, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia
Online First: December 01, 2019 | Cite this Article
Pramana, I., Oka, A., Duarsa, G., Santosa, K., Yudiana, I., Tirtayasa, P. 2019. The short-term disadvantageous of tension-suture and spica cast application in exstrophy-epispadias complex reconstruction: a case report. Intisari Sains Medis 10(3). DOI:10.15562/ism.v10i3.605


Background: Exstrophy-epispadias complex (EEC) represents a spectrum of genitourinary malformations and associated with another congenital anomaly. EEC is a rare congenital disability. EEC affects the genitourinary system, anterior abdominal wall, musculoskeletal system, spine and anus. The surgical outcome has a lot of potential complications in patient with EEC. The decision to first approach is important for the next step. Herein, we reported a case of EEC with several anomalies.

Case Description: A new-born male was born with section cesarean at 38 weeks of gestation from 34-year-old mother, and this is from the second pregnancy. The weight was 3300 grams, and the height was 48 centimetres. There was an abdominal wall defect with an exposed evaginated bladder plate with urine draining from the defect. A complete dorsally opened urethral plate was seen from the bladder neck down to the glandular grove. The patient was diagnosed with Exstrophy-epispadias complex (EEC). A 2 stage repair was conducted in this patient. After 10 days post-operation, the wound became dehiscence and got sepsis postoperatively as well as lead to die in the day 20.

Conclusion: Wound dehiscence following reconstruction is very critical inpatient with EEC. Tension suture and spica cast application can be disadvantageous inpatient with EEC.

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