One-Stage Delayed Bladder Exstrophy Closure Combined With Kelly Repair: Early Outcomes Following the 100-Case Milestone

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PURPOSE: We evaluated bladder dehiscence after 1-stage delayed closure of bladder/cloacal exstrophy combining bladder plate closure with Kelly procedure, with or without osteotomy. MATERIALS AND METHODS: We conducted a multicenter retrospective study of children with bladder exstrophy or cloacal exstrophy who underwent single-stage closure with Kelly mobilization (October 2015-October 2025), by one surgical team, in France and tertiary centers abroad. The primary end point was bladder dehiscence within 3 months. Secondary end points were early (<3 months) complications. Outcomes were analyzed separately for primary repairs and complex cases. RESULTS: = .02). CONCLUSIONS: Single-stage delayed closure combined with Kelly mobilization allows reliable bladder closure with no early dehiscence in bladder/cloacal exstrophy. Early morbidity rate was < 20%, with predominantly low-grade complications. When pubic approximation was difficult, osteotomies or fascial flaps appeared to offer better early parietal outcomes than rectus muscles transposition.

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