Perioperative outcomes in pediatric bladder exstrophy-epispadias complex: Case series of modern staged repair at a tertiary care center in bangalore

Introduction: Bladder Exstrophy-Epispadias Complex (BEEC) constitutes a rare congenital anomaly that profoundly affects the genitourinary system, posing unique challenges in surgical management. The Modern Staged Repair of Exstrophy (MSRE) has emerged as an attempt to achieve functional and anatomical correction. This study reviews the perioperative and long-term outcomes of patients with BEEC treated with MSRE at a tertiary care centre in Bangalore. Methods: his retrospective case series comprises eight patients diagnosed with BEEC and managed with MSRE. Data were extracted from electronic medical records, focusing on patient demographics, clinical characteristics, surgical complications, and continence outcomes. Patient and surgical factors were systematically categorised. Descriptive statistics were employed to summarise the data and identify trends. Results: The study cohort comprised six males and two females, all diagnosed postnatally. Only one patient had a favourable bladder plate, with 87.5% having poor bladder quality, complicating primary repair. Wound leakage occurred in all patients, with fistula in 25 % of cases. Infections were seen in 25% of cases, which were managed conservatively. Continence was achieved in only one patient (12.5%), while the remaining patients remained incontinent. One patient was lost to follow-up. Key challenges included anatomical variability, timing of interventions, and complications from ureteric reimplantation. Conclusion: Managing BEEC requires early intervention, skilled surgical approaches, and comprehensive follow-up. This study accentuates the necessity for early diagnosis and recommends multidisciplinary care, long-term follow-up, and tailored management plans to enhance surgical outcomes and address psychosocial factors affecting patients.