Continence and classic bladder exstrophy treated with staged repair
Abstract
Urinary continence rates after reconstruction of the urinary tract for classic bladder exstrophy are variable. We review our experience with procedures required to optimize continence. We retrospectively reviewed the charts of patients with classic bladder exstrophy undergoing staged reconstruction between 1976 and 2001. Continence was reviewed and associated with the procedures performed. Patients were considered continent if dry for greater than 3 hours with no stress incontinence and dry at night. Partial continence required dryness for 1 to 3 hours, minor stress incontinence and occasional nighttime leakage. Incontinent patients were dry for less than 1 hour, had significant stress incontinence or were wet at night. Patients were followed for a median of 12.5 years. Continence was achieved in 43 of 48 patients (90%), partial continence in 4 (8%) and 1 (2%) remains incontinent. Continence occurred before bladder neck repair in 4 patients. Bladder neck repair alone (without augmentation) was performed in 38 patients at a median of 4.25 years, resulting in continence in 13 patients (34%). However, 6 of these 13 patients later required augmentation. Augmentation was performed in 33 patients, with 30 (91%) attaining continence a...Continue Reading
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