Jayman J, et al. - Given that a successful primary closure is important for optimizing reconstructive outcomes, and it is a critical first-step in the reconstruction of cloacal exstrophy (CE), researchers sought for factors affecting primary bladder closure in CE. They reviewed a prospectively maintained database of 1332 exstrophy-epispadias complex (EEC) patients for CE patients closed between 1975 and 2015. Findings suggested that for a successful primary closure in CE, using the staged approach with a pelvic osteotomy is significant. Using the staged approach and osteotomy were thus the identified factors independently increasing the chance for a successful primary bladder closure.