Journal of Indian Association of Pediatric Surgeons · 2025
Study of Surface Area of Opened Bladder Converted into Bladder-plate in Cadavers and Comparison with Bladder-plate Surface Area in Clinical Cases of Bladder Exstrophy.
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Kumari Prity, Rai Rahul Kumar, Gupta Archika, Kumar Piyush, Kumar Navneet, Rawat J D, Kureel S N
Аннотация
OBJECTIVES: To study the ratio of surface area of bladder converted into bladder-plate, after it has been laid-open, and infra-umbilical anterior-abdominal-wall surface-area in cadavers, and its comparison with clinical cases of bladder exstrophy using same ratio.
METHODS: The study was conducted in ten fresh cadavers, available in the department of anatomy for dissection and 20 bladder exstrophy undergoing repair in the department of pediatric surgery. In cadavers, surface area of infraumbilical anterior-abdominal-wall was calculated after placing horizontal and midline vertical measuring tapes and by counting the number of squares (1 cm2) and mini squares (1 mm2). Bladder was accessed up to verumontanum, taken out and was laid-open via vertical midline cut like a book on graph paper. Bladder-plate surface area was calculated by counting the number of squares and mini-squares. Ratio of infra-umbilical anterior-abdominal-wall surface-area and bladder-plate surface-area was calculated. In exstrophy cases, bladder-plate surface-area and infra-umbilical anterior-abdominal-wall surface-area was calculated after placing vertical and horizontal measuring strips across the bladder-plate and infraumbilical anterior-abdominal-wall as in cadavers and ratio was calculated. The findings of clinical cases were compared with findings found in the cadaveric study.
RESULTS: In cadavers, the ratio of laid-open bladder-plate surface-area and infra-umbilical anterior-abdominal-wall surface-area ranged from 33.4% to 50.5%. In clinical cases, ratio ranged from 7.5% to 12.5% in patients with small bladder-plate (n = 11), 16.7%-19.7% in patients with moderate bladder-plate (n = 3), and 23.8%-37.2% in patient with good bladder-plate (n = 6).
CONCLUSION: In exstrophy cases, bladder-plate surface-area being 24%-37% of infra-umbilical anterior-abdominal-wall (nearer to findings in cadaver control) is the objective criteria of good bladder-plate which is likely to be predictor of good outcome after repair.
METHODS: The study was conducted in ten fresh cadavers, available in the department of anatomy for dissection and 20 bladder exstrophy undergoing repair in the department of pediatric surgery. In cadavers, surface area of infraumbilical anterior-abdominal-wall was calculated after placing horizontal and midline vertical measuring tapes and by counting the number of squares (1 cm2) and mini squares (1 mm2). Bladder was accessed up to verumontanum, taken out and was laid-open via vertical midline cut like a book on graph paper. Bladder-plate surface area was calculated by counting the number of squares and mini-squares. Ratio of infra-umbilical anterior-abdominal-wall surface-area and bladder-plate surface-area was calculated. In exstrophy cases, bladder-plate surface-area and infra-umbilical anterior-abdominal-wall surface-area was calculated after placing vertical and horizontal measuring strips across the bladder-plate and infraumbilical anterior-abdominal-wall as in cadavers and ratio was calculated. The findings of clinical cases were compared with findings found in the cadaveric study.
RESULTS: In cadavers, the ratio of laid-open bladder-plate surface-area and infra-umbilical anterior-abdominal-wall surface-area ranged from 33.4% to 50.5%. In clinical cases, ratio ranged from 7.5% to 12.5% in patients with small bladder-plate (n = 11), 16.7%-19.7% in patients with moderate bladder-plate (n = 3), and 23.8%-37.2% in patient with good bladder-plate (n = 6).
CONCLUSION: In exstrophy cases, bladder-plate surface-area being 24%-37% of infra-umbilical anterior-abdominal-wall (nearer to findings in cadaver control) is the objective criteria of good bladder-plate which is likely to be predictor of good outcome after repair.