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Late failure of the reconstructed exstrophy bladder

C R Woodhouse1, N G Redgrave

  • 1Institute of Urology, London, UK.

British Journal of Urology
|April 1, 1996
PubMed
Summary

Long-term bladder closure and reconstruction in bladder exstrophy patients can fail. Late-onset detrusor or urethral failure may occur due to bladder outlet obstruction from neck tightening.

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Area of Science:

  • Pediatric Urology
  • Reconstructive Surgery

Background:

  • Bladder exstrophy requires surgical reconstruction in infancy.
  • Long-term durability of these reconstructions into adulthood is not well-established.

Purpose of the Study:

  • To assess the durability of bladder closure and bladder neck reconstruction in adult exstrophy survivors.
  • To investigate if bladder outlet obstruction from reconstruction leads to late bladder or urethral failure.

Main Methods:

  • Retrospective review of 57 patients with bladder exstrophy diagnosed between 1965 and 1974.
  • Analysis of outcomes including need for further surgery or diversion.

Main Results:

  • Of 32 reconstructed patients, 13 retained their native bladder into their second decade.
  • Eight of these 13 required further surgery for poor bladder compliance, low capacity, or incontinence.
  • Two patients retained their native bladder but require self-catheterization.

Conclusions:

  • Initially successful exstrophy closures require long-term monitoring.
  • Late detrusor or urethral failure can occur, potentially linked to bladder outlet obstruction from bladder neck reconstruction.

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