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Do patients with classic bladder exstrophy have fecal incontinence? A web-based study
Yaser El-Hout1, Joao L P Salle, Thamer Al-Saad
1Division of Urology, Hospital for Sick Children, Toronto, ON, Canada.
Urology
|November 17, 2009
Summary
Fecal incontinence is common in patients with classic bladder exstrophy (CBE), affecting over half of pediatric and nearly half of adult patients. Ureterosigmoidostomy diversion significantly increases the risk of fecal incontinence in CBE patients.
Area of Science:
- Urology
- Pediatric Surgery
- Gastroenterology
Background:
- Classic bladder exstrophy (CBE) is a complex congenital condition.
- Fecal continence is a significant concern for patients with CBE, impacting quality of life.
- Previous research has not fully elucidated the prevalence of fecal incontinence in CBE patients.
Purpose of the Study:
- To investigate the occurrence and prevalence of fecal incontinence in patients diagnosed with classic bladder exstrophy (CBE).
- To assess the impact of age and surgical history, specifically ureterosigmoidostomy (US) diversion, on fecal continence in CBE patients.
Main Methods:
- A web-based pilot study was conducted using a questionnaire to assess fecal continence status.
- The survey included questions on demographics, age of toilet training, and perceived fecal soiling during day and night.
- Data were collected from 324 CBE patients, with 94 responders analyzed in pediatric and adult groups.
Main Results:
- Fecal incontinence was reported by 57% of pediatric and 44% of adult CBE patients during the day.
- Nighttime fecal incontinence affected 32% of pediatric and 40% of adult patients.
- Patients who underwent ureterosigmoidostomy diversion had significantly higher rates of fecal incontinence (100% day, 86% night) compared to those without (22% day, 22% night).
Conclusions:
- Fecal incontinence is a prevalent and potentially overlooked issue in patients with classic bladder exstrophy, persisting into adulthood.
- The findings highlight the need for increased clinical awareness and proactive management strategies for fecal incontinence in CBE.
- Further research is warranted to explore the impact of specific surgical procedures and the degree of quality of life impairment associated with fecal incontinence in CBE patients.
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