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Genital reconstruction in exstrophy patients.

R B Nerli1, S S Shirol, Ajay Guntaka

  • 1Department of Urology, KLES Kidney Foudation, Belgaum, Karnataka, India.

Indian Journal of Urology : IJU : Journal of the Urological Society of India
|December 4, 2012
PubMed
Summary

Genital reconstruction surgery in male bladder exstrophy patients can significantly improve sexual function and cosmetic appearance. Procedures like chordee correction and penile lengthening lead to high patient satisfaction and improved quality of life.

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Area of Science:

  • Urology
  • Pediatric Surgery
  • Reconstructive Surgery

Background:

  • Bladder exstrophy management has shifted focus from survival to quality of life.
  • Sexual function in adolescent and adult males is a primary long-term concern.
  • Penile anomalies, including shortness and chordee, are common in exstrophy patients.

Purpose of the Study:

  • To evaluate the outcomes of genital reconstructive surgery in male exstrophy patients.
  • To assess patient satisfaction with cosmetic and functional results.
  • To report on techniques for correcting chordee and penile length discrepancies.

Main Methods:

  • Retrospective review of 14 adolescent/adult male patients from 2000-2009.
  • Surgical procedures included epispadias repair, chordee correction, and penile lengthening.
Keywords:
Exstrophyfunctiongenital reconstructionoutcome

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  • Patient satisfaction was assessed using questionnaires and the SF-36.

    • Main Results:

    • Procedures included epispadias repair (3), chordee correction (4), and chordee correction with penile lengthening (7).
    • Penile lengthening by partial corporal dissection yielded a mean increase of ~1.6 cm.
    • All patients reported satisfaction with cosmetic and functional outcomes.

    Conclusions:

    • Genital reconstruction significantly enhances cosmetic and functional outcomes in bladder exstrophy patients.
    • Surgical correction of chordee and penile lengthening can be successfully performed.
    • Improved external genitalia contribute to a satisfactory cosmetic and functional system for patients.