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Development of Late Continence in Bladder Exstrophy and Epispadias Patients
- Source :
- Urology. 144:194-197
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- OBJECTIVE To evaluate to what extend urinary continence develops during puberty in patients with classic bladder exstrophy (CBE) and epispadias. METHODS The operative database was reviewed for surgical procedures and urinary continence in all 65 CBE and epispadias patients born in 1976-2005. Excluded were 2 patients who had insufficient data for evaluation. RESULTS Thirty-five patients with volitional voiding were incontinent at the age of 10 years, 27 had daily incontinence, and 8 had rare incontinence. Sixteen patients (46%) became later fully continent without any major surgery (except Deflux injections in 3 patients) or CIC treatment. Among these 16 fully continent patients there were 7/8 with rare incontinence, 9/23 with daily incontinence (P = .04); 3/9 males with CBE, 10/13 males with epispadias, 3/5 females with CBE, and 0/4 females with epispadias (P = .25 between sex and P =.48 between diagnosis). Of the 15 patients remaining incontinent, 10 had daily and 5 had rare incontinence episodes. The latest control was at the median age of 19 years (interquartile range 17-21 years). Twenty-five patients (40% of the whole material) were fully continent (11/38 (29%) with CBE and 14/25 (56%) with epispadias, P =.04) and 8 (13%) had rare incontinence with volitional voiding (1/38 [3%] with CBE and 7/25 [28%] with epispadias). CONCLUSION Almost half of the incontinent CBE and epispadias patients with volitional voiding achieved continence after the age of 10 without major surgery. Prognosis for pubertal development of continence was best in patients with rare incontinence and in males with epispadias. UROLOGY 144: 194-197, 2020. (c) 2020 Elsevier Inc.
- Subjects :
- Male
medicine.medical_specialty
Epispadias
Adolescent
Urology
Remission, Spontaneous
Population
030232 urology & nephrology
Urination
Severity of Illness Index
03 medical and health sciences
0302 clinical medicine
Interquartile range
Humans
Medicine
In patient
Child
education
TERM-FOLLOW-UP
POPULATION
OUTCOMES
education.field_of_study
Urinary continence
business.industry
Bladder Exstrophy
Puberty
Surgical procedures
Prognosis
3126 Surgery, anesthesiology, intensive care, radiology
medicine.disease
3. Good health
Surgery
Bladder exstrophy
Urinary Incontinence
INCONTINENCE
030220 oncology & carcinogenesis
Female
COMPLETE PRIMARY REPAIR
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 00904295
- Volume :
- 144
- Database :
- OpenAIRE
- Journal :
- Urology
- Accession number :
- edsair.doi.dedup.....e532523d41d96cbbd8b56df5870d0ad6