Preoperative Bladder Capacity Predicts Social Continence following Bladder Neck Reconstruction in Children Born with...

Area of Science:

• Urology
• Pediatric Surgery
• Reconstructive Surgery

Background:

• Bladder exstrophy and epispadias are complex congenital anomalies requiring reconstructive surgery.
• The Young-Dees-Leadbetter bladder neck reconstruction is a surgical technique used to address urinary incontinence in these patients.
• Assessing the long-term outcomes of this procedure is crucial for patient management.

Purpose of the Study:

• To evaluate the rates of urinary continence and volitional voiding in patients who underwent Young-Dees-Leadbetter bladder neck reconstruction.
• To identify factors that predict successful continence after this surgical procedure.

Main Methods:

• Retrospective review of 27 patients with exstrophy-epispadias treated between 1997 and 2019.
• Analysis of demographic and clinical data, focusing on continence and volitional voiding outcomes.
• Categorization of continence into incontinent, socially continent, and fully continent statuses.

Main Results:

• The study included 24 classic exstrophy and 3 isolated complete epispadias patients.
• Overall, 33% achieved full continence, and 67% achieved social continence.
• A preoperative bladder capacity of 110 mL or greater was significantly associated with achieving social continence (OR=6.4, p=0.047).
• The volitional voiding rate was 67%.

Conclusions:

• Young-Dees-Leadbetter bladder neck reconstruction provides moderate rates of social continence (67%) and volitional voiding (67%) in exstrophy-epispadias patients.
• These outcomes are comparable to those reported by high-volume centers.
• Preoperative bladder capacity is a key predictor of social continence following this procedure.