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Related Experiment Videos

How well do patients with exstrophy actually void?

E B Yerkes1, M C Adams, R C Rink

  • 1Division of Pediatric Urology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

The Journal of Urology
|August 25, 2000
PubMed
Summary
This summary is machine-generated.

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Bladder exstrophy reconstruction can achieve continence, but many patients experience voiding problems. This study highlights the high rate of emptying issues despite successful continence, questioning the long-term voiding normalcy.

Area of Science:

  • Pediatric Urology
  • Reconstructive Surgery

Background:

  • Bladder exstrophy requires complex surgical management.
  • Achieving urinary continence and preserving renal function are primary goals.
  • The Young-Dees-Leadbetter bladder neck reconstruction aims for continence without intermittent catheterization.

Purpose of the Study:

  • To evaluate the long-term voiding dynamics in patients with bladder exstrophy who underwent Young-Dees-Leadbetter bladder neck reconstruction.
  • To assess the incidence of clinical and urodynamic problems related to emptying in patients achieving continence.

Main Methods:

  • Retrospective analysis of 53 patients with exstrophy-epispadias complex since 1985.
  • Focused on 27 patients who underwent Young-Dees-Leadbetter bladder neck reconstruction and had at least 2 years of follow-up.

Related Experiment Videos

  • Collected subjective and objective data on voiding function and complications.

    • Main Results:

    • 18 of 27 patients achieved continence with 2-hour dry intervals.
    • Despite subjective continence, 72% of these patients experienced clinical problems (UTIs, epididymitis, calculi).
    • Objective urodynamic studies confirmed poor voiding efficiency in most patients.

    Conclusions:

    • Young-Dees-Leadbetter bladder neck reconstruction can achieve continence in bladder exstrophy patients without intermittent catheterization.
    • However, a significant proportion of these patients develop emptying-related complications.
    • The study questions the normalcy of voiding patterns and the overall cost of achieving continence in this population.