World Journal of Urology

, Volume 24, Issue 3, pp 244–249 | Cite as

Standing the test of time: long-term outcome of reconstruction of the exstrophy bladder

  • C. R. J. Woodhouse
  • Amanda C. North
  • John P. Gearhart
Topic Paper


The surgical management of classic bladder exstrophy has evolved over time. Different techniques are used to address the challenge of reconstructing these patients. We review the long-term outcomes of bladder exstrophy treatment from the published literature with regard to urinary continence, voiding and secondary complications. Continence now can be achieved in up to 80% of children in specialist centres. Whether such success can sustained into adult life is uncertain. About 40% of adults are dry in the best hands. Up to 84% of children can void, but there is some evidence that this function is lost with time in 70%. The need for bladder augmentation is widely variable between series, reported in 0–70% of children. This reduces the ability to void spontaneously to about 50% of children. It brings with it the later risk of metabolic disturbance and stone formation. Adults with exstrophy have a 694-fold increase in the risk of bladder cancer by the age of 40 years.


Bladder exstrophy Urinary incontinence Follow-up 


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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • C. R. J. Woodhouse
    • 1
    • 2
  • Amanda C. North
    • 1
    • 2
  • John P. Gearhart
    • 1
    • 2
  1. 1.The Institute of UrologyUniversity College LondonLondonUK
  2. 2.Division of Paediatric Urology, James Buchanan Brady Urological InstituteThe Johns Hopkins HospitalBaltimoreUSA

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