Abstract：
The bladder-Exstrophy-Epispadias complex (BEEC) contains a wide spectrum of congenital malformations. A treatment naïve refugee was referred to our center with what was identified as BEEC.
A 27-year-old female patient was referred for total incontinence since birth by the general practitioner from the refugee center. An exstrophic bladder with blind ending ureteral orifices and a second non-exstrophic bladder with two orthotopic ureters was identified, demonstrating the bladder duplication in the sagittal plane. Laparotomy was performed, dissecting the exstrophic bladder plate caudally and using it as a ventral onlay to augment the non-exstrophic bladder. A Mitchell-type bladder neck reconstruction was performed with an autologous fascia sling around the bladder neck to obtain continence. As the patient had never voluntarily voided, chances of spontaneous voiding after surgery were low. Therefore creation of a continent Mitrofanoff-type vesicostomy was additionally realized and genital reconstruction was achieved.
12 months post operatively, the patient was completely continent, had a bladder capacity of 250 ml, and performed self-catheterization 5 times a day. No post-operative complications were observed.
Admission of political refugees can implicate challenging surgeries for congenital malformations in adults, such as BEEC. This demonstrates the importance of multidisciplinary transitional care.
A 27-year-old female patient was referred for total incontinence since birth by the general practitioner from the refugee center. An exstrophic bladder with blind ending ureteral orifices and a second non-exstrophic bladder with two orthotopic ureters was identified, demonstrating the bladder duplication in the sagittal plane. Laparotomy was performed, dissecting the exstrophic bladder plate caudally and using it as a ventral onlay to augment the non-exstrophic bladder. A Mitchell-type bladder neck reconstruction was performed with an autologous fascia sling around the bladder neck to obtain continence. As the patient had never voluntarily voided, chances of spontaneous voiding after surgery were low. Therefore creation of a continent Mitrofanoff-type vesicostomy was additionally realized and genital reconstruction was achieved.
12 months post operatively, the patient was completely continent, had a bladder capacity of 250 ml, and performed self-catheterization 5 times a day. No post-operative complications were observed.
Admission of political refugees can implicate challenging surgeries for congenital malformations in adults, such as BEEC. This demonstrates the importance of multidisciplinary transitional care.
摘要：
背景：膀胱-外翻-外翻综合征（BEEC）包含广泛的先天性畸形。一名天真的难民被称为我们的中心，被称为BEEC。
方法：一名27岁女性患者因出生后完全失禁而被难民中心的全科医生转诊。确定了一个带有盲端输尿管口的异型膀胱和第二个带有两个原位输尿管的非异型膀胱，在矢状面显示膀胱重复。进行了剖腹手术，尾端解剖外生膀胱板，并将其用作腹侧包以扩大非外生膀胱。在膀胱颈周围使用自体筋膜吊带进行Mitchell型膀胱颈重建，以获得节制。由于病人从未自愿作废，手术后自发排尿的几率很低.因此，还实现了大陆Mitrofanoff型膀胱造口术的创建，并实现了生殖器重建。
结果：术后12个月，病人完全是大陆，膀胱容量为250毫升，每天进行5次自我导尿。术后无并发症发生。
结论：接纳政治难民可能涉及成人先天性畸形的挑战性手术，比如BEEC。这表明了多学科过渡护理的重要性。
方法：一名27岁女性患者因出生后完全失禁而被难民中心的全科医生转诊。确定了一个带有盲端输尿管口的异型膀胱和第二个带有两个原位输尿管的非异型膀胱，在矢状面显示膀胱重复。进行了剖腹手术，尾端解剖外生膀胱板，并将其用作腹侧包以扩大非外生膀胱。在膀胱颈周围使用自体筋膜吊带进行Mitchell型膀胱颈重建，以获得节制。由于病人从未自愿作废，手术后自发排尿的几率很低.因此，还实现了大陆Mitrofanoff型膀胱造口术的创建，并实现了生殖器重建。
结果：术后12个月，病人完全是大陆，膀胱容量为250毫升，每天进行5次自我导尿。术后无并发症发生。
结论：接纳政治难民可能涉及成人先天性畸形的挑战性手术，比如BEEC。这表明了多学科过渡护理的重要性。
