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

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Abstract

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.

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Authors and Affiliations

  1. The Institute of Urology, University College London, 48, Riding House Street, W1W 7EY, London, UK

    C. R. J. Woodhouse, Amanda C. North & John P. Gearhart

  2. Division of Paediatric Urology, James Buchanan Brady Urological Institute, The Johns Hopkins Hospital, Marburg 149, Baltimore, MD, 21287, USA

    C. R. J. Woodhouse, Amanda C. North & John P. Gearhart

Authors
  1. C. R. J. Woodhouse
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  2. Amanda C. North
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  3. John P. Gearhart
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Correspondence to C. R. J. Woodhouse.

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Woodhouse, C.R.J., North, A.C. & Gearhart, J.P. Standing the test of time: long-term outcome of reconstruction of the exstrophy bladder. World J Urol 24, 244–249 (2006). https://doi.org/10.1007/s00345-006-0053-7

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  • DOI: https://doi.org/10.1007/s00345-006-0053-7

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