Recto sigmoid bladder reservoir for patients with exstrophy: three dimensional evaluation for outcome analysis

Area of Science:

• Urology
• Pediatric Surgery
• Reconstructive Surgery

Background:

• Bladder exstrophy (BE) presents complex reconstructive challenges.
• Ureterosigmoidostomy (US) is a common diversion technique, but outcomes vary.
• Standardized evaluation methods for BE reconstruction are needed.

Purpose of the Study:

• To evaluate the outcomes of recto sigmoid bladder reservoir (RSBR), a modified US technique.
• To assess urinary continence, upper tract status, and health-related quality of life (HRQOL).
• To introduce a novel three-dimensional evaluation system for BE patients.

Main Methods:

• Retrospective evaluation of 19 BE patients who underwent RSBR with at least 1-year follow-up.
• Assessment using a three-dimensional system: rectal continence, renal function, and HRQOL.
• Mean follow-up of 3.4 years, mean age at RSBR of 5.1 years.

Main Results:

• 10 patients achieved good rectal continence; 9 experienced occasional minimal urine leakage.
• Renal function was preserved in all but one patient.
• Mean HRQOL score was 129.7/150, indicating significant improvement.

Conclusions:

• RSBR surgery significantly enhances HRQOL in BE patients.
• The proposed three-dimensional assessment system provides a comprehensive evaluation method.
• Standardized reporting via this system can facilitate multi-center comparisons for US outcomes.