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Exstrophy of bladder: evolution of management
Insights
This study reviewed 89 bladder exstrophy cases over 50 years, finding a 50% success rate with planned, multistaged reconstruction for eligible children. Failures often resulted from persistent incontinence after ileal conduit diversion.
Area of Science:
- Pediatric Urology
- Congenital Anomalies
- Surgical Reconstruction
Background:
- Bladder exstrophy is a rare congenital anomaly requiring complex surgical management.
- Long-term outcomes for bladder exstrophy reconstruction have historically varied.
Abstract:
Eighty-nine patients with bladder exstrophy were seen at our institution over the last fifty years. There were 63 males and 26 females. Cloacal exstrophy constituted 9 per cent of our experience. Twenty-seven patients underwent primary urinary diversion with subsequent genital reconstruction early on in our series. Of the 57 children operated on since 1951, 50 were judged eligible for and underwent a planned multistaged reconstruction. We realized a 50 per cent success rate. The majority of failures were diverted into an ileal conduit for persistent incontinence.