Prune belly's babies survived with abdominal wall muscular weakness and disfigurement, and which age we can reconstruct their abdomen? and is it feasible to use mesh for strengthening of their muscles? and which type of mesh is suitable?
Dear Mohamed, In my limited experience, the abdominal wall reconstruction can be done at the same time as the orchidopexy as an open procedure through a midline laparotomy. This should be done by 18months of age. This way it can be possible to preserve the testicular vessels.
I would not use mesh as it will not grow with the child and make subsequent reconstructive surgery more difficult.
Dear Mohamed, Of course, the decision is yours but I think that this process is not a necessary surgery. The patient with Prune belly syndrome already has too many problems. This additional invasive intervention can cause new problems and burdens to the patient. I wish success. Yours truly.
Dear Ozkan
You are absolutely right, but we are talking about those children who survive the critical situation, and abdominal wall reconstruction may help cough, proper defecation and bladder evacuation.
Article Dynamic Abdominoplasty for the Treatment of Prune Belly Syndrome
Dear Mohamed, I think I missed the point. Your plan can be right. I have just said to myself because of my negative experience.
I would not be in a hurry to operate. Attention to bladder function is the first priority. I have one Prune Belly that never required surgery beyond my cinching up the trigone where it had been so weak and flexible that it would flip up and block the bladder neck. This boy is now in his fifties and with family and all.
I totally do agree With RP Lyon opinion that we should not be in a hurry for operation.
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