Probability of Bladder Augmentation, Diversion and Clean Intermittent Catheterization in Classic Bladder Exstrophy: A 36-Year, Multi-Institutional, Retrospective Cohort Study

Szymański, Konrad M.; Fuchs, Molly; McLeod, Daryl J.; Rosoklija, Ilina; Strine, Andrew C.; VanderBrink, Brian A.; Whittam, Benjamin; Yerkes, Elizabeth B.; Gargollo, Patricio C.

doi:10.1097/ju.0000000000000552

Cited by 13 publications

(8 citation statements)

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“…Modified BNR to gain urinary continence is reportedly required in 15-90% of patients, with 5-10% requiring both BA and BNR. In our case series, as in the recent report of Szymanski et al (2019), BA was preferred in approximately 50% of children with BE and their quality of life was improved significantly by BA/CIC/Mitrofanoff regimen with obtaining satisfactory continence in 26 (78.7%) children. With a shorter follow-up of 3 years (1 month to 7 years), a study by Shoukry et al revealed patients became dry only after augmentation cystoplasty (Shoukry et al, 2009).…”

Section: Discussionsupporting

confidence: 79%

“…The timing of BA is another issue to be considered. In a multi‐institutional, retrospective cohort study (2019) conducted by Szymanski et al, the probability of bladder augmentation/diversion increased with age (Szymanski et al, 2019). On survival analysis, the probability of BA/diversion was 14.9% by age 5 years, 50.7% by 10 years, and 70.1% by 18 years.…”

Section: Discussionmentioning

confidence: 99%

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Bladder augmentation in exstrophy vesicae: Long‐term results of a single experienced center

Demirkan

Kuzdan²

2022

Birth Defects Research

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Background: In this study, we present our long-term treatment outcomes of bladder augmentation (BA), bladder neck closure, and Mitrofanoff clean intermittent catheterization (CIC) in managing bladder exstrophy (BE). Methods: This was a retrospective medical records' review of 33 children diagnosed as born with BE, followed up at a tertiary pediatric urology clinic from 1988 to 2020. Outcomes such as surgical interventions, presence of renal calculi, hydronephrosis, and continence status were extracted. Results:The median follow-up of the group was 18.2 (4-26) years. Urinary system stones developed in 10 (30.3%) cases about 8.9 years after BA. Stone development was two times more common in patients who underwent colocystoplasty (33.3%) than those who underwent ileocytoplasty (16.6%). The state of continence of the group was satisfactory in 26 (78.7%; excellent in 23; good in 3 cases) and unsatisfactory (wet) in 6 (18.1%) cases. At the last visit, ultrasonography revealed no hydronephrosis in 23 (69.6%) patients, and the voiding cystourethrogram demonstrated low-grade vesicoureteral reflux in 10 (30.3%) and high-grade vesicoureteral reflux in 2 (6%) patients.Conclusions: An elaborated plan of surgical reconstruction for classic BE can lead to satisfactory long-term urinary continence in most patients. Ultimate predictors of outcome in BE repair are difficult to ascertain. Consistently, BA, bladder neck closure, and Mitrofanoff CIC continue to stand out at a critical point in the management of those patients with classic BE. Our study demonstrated that augmentation is required to achieve acceptable dryness with high satisfactory dryness rates in BE.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Bladder augmentation in exstrophy vesicae: Long‐term results of a single experienced center

Demirkan

Kuzdan²

2022

Birth Defects Research

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“…Bladder outlet obstruction after BNR is a known phenomenon and it can lead to detrusor failure or impairment of bladder compliance and stability 13,14 . Recent study from USA supported this, as majority of the CBE patients needed bladder augmentation within 10 years after BNR 15 . Only 14% of adult CBE patients did not need to perform CIC as there was increasing need for augmentation during puberty 15 .…”

Section: Discussionmentioning

confidence: 79%

“…Recent study from USA supported this, as majority of the CBE patients needed bladder augmentation within 10 years after BNR 15 . Only 14% of adult CBE patients did not need to perform CIC as there was increasing need for augmentation during puberty 15 . Also in our previous study with adult CBE and epispadias patients, as well as in previous French study with CBE patients, majority of patients without bladder augmentation had disturbing symptoms related with poor bladder emptying 3,12 .…”

Section: Discussionmentioning

confidence: 79%

Development of Late Continence in Bladder Exstrophy and Epispadias Patients

Taskinen

Suominen

Mäkelä

2020

Urology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Bladder exstrophy closure is a critical concern during the initial few years of life. 6 But what about the later need for augmentation, diversion and assisted drainage with intermittent catheterization? This article examines these concerns using data stretching over 3 decades.…”

Section: Probability Of Bladder Augmentation Diversion and Clean Inte...mentioning

confidence: 99%

This Month in Pediatric Urology

Wan¹

2020

Journal of Urology

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In 2006 the Spina Bifida Association conducted a survey that identified differences in how care and services are delivered. To address these gaps, the association's Professional Advisory Council recommended creation of a national database to collect the data needed to make meaningful improvements in care. Established in 2008, the National Spina Bifida Patient Registry is managed and funded by the Centers for Disease Control and Prevention.

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Probability of Bladder Augmentation, Diversion and Clean Intermittent Catheterization in Classic Bladder Exstrophy: A 36-Year, Multi-Institutional, Retrospective Cohort Study

Cited by 13 publications

References 0 publications

Bladder augmentation in exstrophy vesicae: Long‐term results of a single experienced center

Bladder augmentation in exstrophy vesicae: Long‐term results of a single experienced center

Development of Late Continence in Bladder Exstrophy and Epispadias Patients

This Month in Pediatric Urology

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