Clinical Trial: Navigation of the Pelvic Floor in Bladder Exstrophy Using Pre-operative MRI

Study Status: Not yet recruiting
Recruit Status: Unknown status
Study Type: Interventional

Official Title: Navigation of the Pelvic Floor in Bladder Exstrophy Using Pre-operative MRI

Brief Summary: The aim of this study is to investigate the use of intraoperative stereotactic imaging of the pelvic floor musculature during closure of bladder exstrophy.

Detailed Summary:

Much of the long-term success of classic bladder exstrophy closures depends on the initial closure. Several studies have demonstrated that a key to successful initial closure involves deep dissection of the pelvic floor so that the bladder can be placed in the most posterior and inferior position possible. Oftentimes, the need for repeat closure of the abdomen is required if the initial surgeon failed to properly dissect deep enough into the child's pelvic floor. Many surgeons are unfamiliar with the complex anatomy and are unable to verify that they have properly reached the true pelvic floor during this initial surgery. This often leads to failed closures, which result in poor continence rates later in life.

The investigators are attempting to determine the safety and efficacy of the use the Brainlab, Inc. VisionVector® Cranial Image Guided Surgery System during closure of bladder exstrophy. The value of this research is two-fold. Firstly, the project will help us to verify if the investigators are indeed dissecting down to the proper plane required for successful initial closure of bladder exstrophy. Secondly, this project will help others with relatively less experience with bladder exstrophy to properly identify where they are anatomically during closure of exstrophy, thus yielding higher success rates and better patient care at other centers.


Sponsor: Johns Hopkins University

Current Primary Outcome: Success or failure of exstrophy closure [ Time Frame: 2 years ]

Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Urinary continence [ Time Frame: 2 years ]
  • Operative time [ Time Frame: Intraoperatively ]
  • Length of hospital stay [ Time Frame: 1 month ]
  • Peri-operative complications [ Time Frame: Intraoperatively ]
  • Subjective improved identification of the pelvic floor anatomy during bladder exstrophy closure as reported by the surgeon [ Time Frame: Intraoperatively ]
  • Post-operative complications [ Time Frame: 2 years ]


Original Secondary Outcome: Same as current

Information By: Johns Hopkins University

Dates:
Date Received: June 7, 2013
Date Started: September 2012
Date Completion: September 2014
Last Updated: June 12, 2013
Last Verified: June 2013