ABSTRACT
We typically perform the complete primary repair of exstrophy (CPRE or Mitchell technique) in the newborn period (Figure 29.1). Primary reconstruction in the newborn period is technically easier than when performed at a later stage. It also offers theoretical advantages observed with normal bladder development that may improve the potential for urinary continence. The bony pelvis also remains pliable in the newborn period so that osteotomies may be avoided in some cases. However, we favor the use of osteotomies in most patients and suggest that osteotomies be used in conjunction with exstrophy closure if at all in doubt.1
