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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
PubMed
Summary
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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.

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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.