. To evaluate to what extend urinary continence develops during puberty in patients with classic bladder exstrophy (CBE) and epispadias.
. The operative database was reviewed for surgical procedures and urinary continence in all 65 CBE and epispadias patients born in 1976-2005. Excluded were two patients who had insufficient data for evaluation.
. Thirty-five patients with volitional voiding were incontinent at the age of 10 years, 27 had daily incontinence and eight had rare incontinence. Sixteen patients (46%) became later fully continent without any major surgery (except Deflux® injections in three patients) or CIC treatment. Among these 16 fully continent patients there were 7/8 with rare incontinence, 9/23 with daily incontinence (p=0.04); 3/9 males with CBE, 10/13 males with epispadias, 3/5 females with CBE and 0/4 females with epispadias (p=0.25 between sex and p=0.48 between diagnosis). Of the 15 patients remaining incontinent, 10 had daily and five had rare incontinence episodes. The latest control was at the median age of 19 years (IQR 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=0.04) and eight (13%) had rare incontinence with volitional voiding [1/38 (3%) with CBE and 7/25 (28%) with epispadias].
. 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. 2020 Jul 03 [Epub ahead of print]
Seppo Taskinen, Janne Suominen, Eija Mäkelä
Department of Pediatric Surgery, New Children´s Hospital, University of Helsinki, Helsinki, Finland. Electronic address: ., Department of Pediatric Surgery, New Children´s Hospital, University of Helsinki, Helsinki, Finland. Electronic address: ., Department of Pediatric Surgery, New Children´s Hospital, University of Helsinki, Helsinki, Finland. Electronic address: .