An Initial Evaluation of Pelvic Floor Function and Quality of Life of Bladder Exstrophy Patients After Ureterosigmoidostomy

Colorectal anomalies in patients with classic bladder exstrophy

“…In addition, up to 25% of children with anorectal malformations have been noted to have neurogenic bladder dysfunction, placing additional risk on an already compromised exstrophied bladder from a structural and neurologic standpoint [12][13][14]. As patients with CBE progress from adolescence into adulthood, longterm GI surveillance is required because issues with abnormal defecation and fecal incontinence are becoming more apparent and clearly have a physical, psychologic, and social impact on the patient and their quality of life [3,15]. Gastrointestinal issues also affect GU reconstruction because fecal continence is mandatory before a patient with exstrophy becomes a candidate for a bladder outlet procedure for urinary continence.…”

“…The widely splayed pelvic bones cause an underlying lack of support of the pelvic genitourinary (GU) organs while also affecting the rectum and the distal colon because the puborectalis muscle is outwardly rotated and more posteriorly located than normal [2]. In addition, recent longitudinal studies of patients with exstrophy in adulthood now recognize that there is significant pelvic floor dysfunction causing issues with defecation and fecal continence that must be addressed [3].…”

Exstrophy epispadias complex- Issues beyond the initial repair

“…In a study of 52 individuals, who had undergone ureterosigmoidostomy before 1990, a significant risk of urofecal incontinence and pelvic organ prolapse was identified. [17] Although risk of tumors has not been a problem in the most recent literature, it needs long-term studies in children. It may not be the primary option but does have a place in children born with very small bladders, exstrophy cripples, and those with limited access to professional medical resources.…”