Surgical Management Of Abdominal Wall Defect In Prune Belly Syndrome – A Systematic Scoping Review Of The Literature

Surgical Management Of Abdominal Wall Defect In Prune Belly Syndrome – A Systematic Scoping Review Of The Literature

Chigozirim I Ejinkeonye , Olawoyin T Olakunle, Karen K Madueke, Jyoti Kumari, Marvellous Sowunmi, Samantha DSR Ferreira, David Izuchukwu Onyebuchi, Habib O Alagbo
International Student Surgical Network (InciSioN) Ukraine, Kiev, Ukraine, Ukraine; Afe Babalola University, Ado-Ekiti, Nigeria, Nigeria; nternational Student Surgical Network (InciSioN) Ukraine, Kiev, Ukraine, Ukraine

Introduction: Prune Belly Syndrome (PBS) is a rare congenital disorder characterised by a triad of abdominal wall musculature deficiency, urinary tract anomalies, and bilateral cryptorchidism, predominantly occurring in males. Abdominal wall repair is critical not only for cosmetic reasons but also for improving internal organ support and function, as well as mobility and posture. However, there is a lack of a comprehensive review of the surgical techniques, outcomes, and complications.

Aim: To provide a review of the surgical approaches for abdominal wall defects in PBS, with their associated functional and cosmetic outcomes, as well as complications.

Methods: A systematic scoping review was conducted across five databases (Scopus, PubMed/MEDLINE, Cochrane, VHL, Web of Science), resulting in the inclusion of 17 studies and 251 patients between 1993 and 2023. Data on surgical techniques, outcomes, and complications were extracted and analysed.

Results: Open surgical methods dominated, with Monfort’s technique and its modifications being the most reported. Other techniques included classical abdominoplasty, plication methods, and laparoscopic approaches. Functional improvements, such as enhanced abdominal tonus, mobility, and micturition, were reported in up to 93.5% of cases, while about 90% had cosmetically satisfactory results in most studies. Complications included skin sloughing (up to 60%), umbilical necrosis, and postoperative relapse.

Conclusion: Surgical intervention for PBS yields high functional and aesthetic benefits, with combined procedures offering holistic care. Despite positive outcomes, the recurrence of flaccidity and notable complications shows the need for standardised protocols and long-term follow-up. Future studies should focus on comparative outcomes and patient-centred approaches.

Keywords: Prune Belly Syndrome, Abdominal Wall Defects, Surgery, Abdominoplasty, Treatment, Outcome