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Long-term adjustment issues in patients with exstrophy
B Montagnino1, D I Czyzewski, R D Runyan
1Scott Department of Urology, Baylor College of Medicine, Houston, Texas, USA.
The Journal of Urology
|September 29, 1998
Summary
Children with bladder or cloacal exstrophy generally adjust well psychologically. Older children and those continent after age four may need targeted support for adaptive and behavioral challenges.
Area of Science:
- Pediatric Psychology
- Urology
- Developmental Pediatrics
Background:
- Bladder exstrophy and cloacal exstrophy are complex congenital anomalies.
- Psychological adjustment in children with these conditions requires careful evaluation.
Purpose of the Study:
- To explore the psychological adjustment of children diagnosed with bladder or cloacal exstrophy.
- To identify factors influencing psychological outcomes in this population.
Main Methods:
- Twenty-nine children with exstrophy (mean age 7.8 years) were assessed using standard psychological instruments.
- Psychological scores were compared to normative data.
- T-tests were used to compare adjustment between dichotomized groups based on medical and demographic factors.
Main Results:
- Children with exstrophy reported positive self-perception of appearance.
- Older children showed deficits in adaptive behaviors, particularly school-related skills.
- Continence achieved after age four correlated with increased acting-out behaviors.
- No significant differences in adjustment were found based on gender, exstrophy type, continence strategy, or gender reassignment.
Conclusions:
- Children with exstrophy do not typically exhibit clinical psychopathology.
- Focus should be on supporting adaptive and behavioral development rather than solely on potential psychological distress.
- Interventions may benefit from targeting age-related adaptive skills and behavioral challenges.