Anatomical and Functional Outcomes of Bladder Exstrophy Patients - A Single-Centre Indonesian Experience

Bladder exstrophy is an embryologic malformation characterised by a deficiency of the anterior midline, resulting in urogenital and skeletal complications. The aim of this article is to identify the factors influencing outcomes in patients with bladder exstrophy, a condition for which published literature remains limited.

A retrospective cohort study analysed medical records from 2011 to 2017. Patients with bladder exstrophy who underwent anterior and posterior innominate osteotomy were evaluated for clinical outcomes in an orthopaedic outpatient clinic. Anatomical outcomes were assessed by calculating the percentage of pubic approximation, while functional outcomes were measured using the PedsQL 4.0 and compared to typical peers.

Nineteen children (median age 6 years) were included: 11 boys (57.9%) and 8 girls (42.1%). Among them, 17 had bladder exstrophy, 2 had cloacal exstrophy, 2 had epispadias, and 1 had hypospadias. Sixteen children (84.2%) had no other congenital anomalies. The median age at surgery was 6 months (range 1-71 months), with a median pubic approximation percentage of 78.5% (range 65- 98.1%). The mean PedsQL score post-operation was 97.2 ± 1.6. A significant correlation was found between age at operation, post-operative diastasis, pubic approximation percentage, and PedsQL score (p < 0.05).

The clinical outcomes for bladder exstrophy patients were favourable, as indicated by pubic approximation percentage and PedsQL scores. Age at operation and post-operative diastasis significantly influenced both anatomical and functional outcomes.