Abdominal wall dysfunction in adult bladder exstrophy: a treatable but under-recognized problem.

Area of Science:

• Urology
• Pediatric Surgery
• Plastic Surgery

Background:

• Bladder exstrophy presents with complex urogenital and skeletal abnormalities, impacting the abdominal wall.
• Current literature primarily addresses neonatal management, with limited long-term follow-up on adult outcomes.
• Adult abdominal wall defects following childhood exstrophy treatment remain under-characterized.

Purpose of the Study:

• To characterize the long-term abdominal wall defects in adult patients with bladder exstrophy.
• To evaluate the effectiveness of tailored reconstructive therapies for adult bladder exstrophy.
• To raise awareness regarding the prevalence and treatability of adult abdominal wall dysfunction.

Main Methods:

• Retrospective review of a consecutive series of six adult patients with bladder exstrophy.
• Characterization of abdominal wall dysfunction and cosmetic/functional deformities.
• Implementation and assessment of individualized abdominal wall and pelvic floor reconstruction.

Main Results:

• Severe abdominal wall dysfunction was identified in adult exstrophy patients.
• Tailored abdominal wall and pelvic floor reconstruction demonstrated long-term success.
• The study highlights the significant, yet often overlooked, challenges faced by adults with bladder exstrophy.

Conclusions:

• The long-term natural history and consequences of bladder exstrophy closure require further investigation.
• Effective reconstructive options exist for adult abdominal wall defects associated with bladder exstrophy.
• Increased awareness and understanding are crucial for improving the quality of life for affected individuals.