Affordable Access

Publisher Website

Urinary Diversion in Bladder Exstrophy and Incontinent Epispadias: 25 Years of Experience

The Journal of Urology
Publication Date
DOI: 10.1016/s0022-5347(01)67026-5
  • Medicine


Abstract Purpose To determine the optimal surgical approach in achieving complete urinary continence with preservation of the upper urinary tract in the exstrophy-epispadias complex we reviewed the records of patients treated at our institution. Materials and Methods From 1968 to July 1994, 115 patients with bladder exstrophy/incontinent epispadias were treated of whom followup was available for 104 and 2 died of causes unrelated to urinary diversion. Mean followup is 16.7 years. In 43 of the 102 patients surgery was primarily performed at our institution (urinary diversion in 39, a modified Young-Dees procedure in 1 and sling plasty in 3). In another 59 patients urinary diversion was done secondarily after therapy elsewhere (bladder closure/bladder neck reconstruction in 34 and failed urinary diversion with incontinence in 22). Urinary diversion was performed in 49 patients, a Young-Dees procedure in 7 and genital reconstruction alone in 3. Results The present continence rates are 96 percent for the rectal reservoir, 97 percent for the Mainz pouch I and 67 percent for the modified Young-Dees augmentation. Upper tracts have remained stable and no bowel neoplasms have developed. Conclusions Rectal reservoirs represent our urinary diversion of choice. After failed reconstruction/insufficient anal sphincter a Mainz pouch I is constructed and when the upper tract has deteriorated a colon conduit is created.

There are no comments yet on this publication. Be the first to share your thoughts.


Seen <100 times

More articles like this

Urinary diversion in bladder exstrophy and inconti...

on The Journal of Urology September 1995

Management of bladder exstrophy and incontinent ep...

on Archivos españoles de urologi... 1997

Pregnancy management in women within the bladder-e...

on Archives of gynecology and obs... October 2011

Urinary diversion in children with mainly exstroph...

on The Central African journal of... December 2000
More articles like this..