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Malaysia’s First Kelly Procedure Performed At Prince Court For Rare Bladder Condition

Kuala lumpur: Prince Court Medical Centre has successfully performed Malaysia’s first Kelly Procedure, a complex reconstructive surgery for bladder exstrophy, marking a major milestone in paediatric urology for the country.

According to BERNAMA News Agency, the procedure was carried out last Monday on a two-year-old boy from Indonesia by Prince Court Consultant Urologist Dr Roger Anthony Idi, in collaboration with Professor Imran Mushtaq, Consultant Paediatric Urologist at Great Ormond Street Hospital, London.

Bladder exstrophy is a rare congenital condition affecting approximately one in 40,000 births, in which the bladder develops outside the body. ‘This condition can be detected through antenatal scans, enabling early consultation and surgical planning,’ Dr Roger said at a press conference today.

Treatment is typically staged, beginning with primary bladder closure shortly after birth, followed by the Kelly Procedure between the ages of two and three. The Kelly Procedure reconstructs the bladder neck using the child’s muscle and soft tissue to create a functional sphincter, the muscle that holds in urine, providing improved bladder control.

‘It also enhances genital appearance and offers the highest continence rates compared to other surgical approaches,’ he said. Without the second-stage surgery, many children remain incontinent into adolescence and adulthood, facing social, psychological and even sexual health challenges.

‘They may withdraw socially, struggle with self-esteem, and face long-term quality of life issues,’ he added. In the past, many Malaysian cases remained untreated or incomplete due to the lack of local specialists trained in this rare and technically demanding procedure.

‘From my experience, we still see children aged five or six presenting with untreated bladder exstrophy. Others had initial closure but never received the Kelly Procedure, resulting in lifelong continence issues,’ Dr Roger said. With the procedure now available at Prince Court, patients no longer need to travel abroad for this life-changing surgery, he noted.

He also stressed the importance of early intervention, noting that younger children have more pliable tissue, increasing the chances of long-term success. ‘Moving forward, we hope to offer this procedure not just to patients in Malaysia, but also across the region and internationally,’ he said.

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