Development of bladder plate calculus on missed sutured surgical sponge following primary bladder exstrophy repair

Bladder Exstrophy (BE) has been considered as a rare congenital malformation of the genitourinary system, with an estimated incidence of approximately 1 per 50,000 live births [1]. The management of this anomaly is complex, involving several surgical reconstructions with numerous challenges to achieve anatomically, functionally, and cosmetically satisfactory outcomes [2]. Furthermore, the management must be early in the first months of life for better functional and cosmetic results [3,4]. Wound dehiscence, urethral outlet obstruction, bladder prolapsed, renal and bladder calculi are among the main complications following failed primary BE closure [5]. Urinary stone formation is estimated to be around 15% following bladder closure, in repaired BE patients, especially in cases living in poor or rural regions [6]. Bladder stone formation may occur following infra-vesical obstruction, neurogenic voiding dysfunction, urinary tract infection, foreign bodies, and metabolic risk factors years after reconstructive surgery [7]. Here, we report a 6-yearold boy with failed BE repair at an early age that was complicated by late surgery outcomes and secondary stone formation on missed sutured surgical sponge post-operatively.