Bladder capacity and growth in classic bladder exstrophy: A novel predictive tool.

Area of Science:

• Pediatric Urology
• Surgical Management of Bladder Exstrophy
• Urinary Continence Prediction

Background:

• Bladder capacity (BC) is crucial for managing classic bladder exstrophy (CBE) patients.
• BC influences eligibility for continence procedures like bladder neck reconstruction (BNR).
• Accurate BC prediction is vital for optimizing surgical outcomes and achieving urinary continence.

Purpose of the Study:

• To develop a predictive nomogram for bladder capacity (BC) in classic bladder exstrophy (CBE) patients.
• To utilize easily accessible clinical parameters for BC prediction.
• To provide a tool for patients and pediatric urologists to estimate BC.

Main Methods:

• Retrospective review of an institutional database of CBE patients.
• Development of a predictive model using linear mixed-effects models.
• Inclusion of factors such as primary closure outcome, sex, age at closure, and time since closure.

Main Results:

• A nomogram was developed incorporating primary closure outcome, sex, age at closure, and time since closure.
• The model demonstrated improved prediction accuracy compared to the age-based Koff equation.
• The nomogram is available as a web-based tool for clinical application.

Conclusions:

• The developed bladder capacity nomogram offers a more accurate prediction for CBE patients.
• The nomogram utilizes accessible clinical data for improved surgical planning.
• Further multi-center validation is recommended for widespread adoption of this CBE bladder growth nomogram.