Abstract General Information

Title

BLADDER EXSTROPHY-EPISPADIAS COMPLEX: THE EFFECT OF UROTHERAPY ON INCONTINENCE.

Introduction and objective

Achieving urinary continence in children with the bladder exstrophy-epispadias complex (BEEC) is a key goal. Unfortunately, this goal is only moderately achieved by extensive surgical treatment. Undergoing repeated hospitalization and extensive operations may consequently have a negative impact on quality of life. Therefore, exploring conservative treatment options early in incontinence treatment is essential.

The aim of this study is to evaluate the benefits of an intensive urotherapy programme on incontinence after reconstructive surgery in children with BEEC

Method

A retrospective chart study included 30 children enrolled in an intensive urotherapy program for persistent incontinence after BEEC reconstructive surgery.
Urotherapy involved a ten-day inpatient program, followed by three months of extensive supervision by experienced urotherapists. The main outcome measurement was continence based on the International Children’s Continence Society definition, as the percentage of children achieving continence (good result) or improvement after treatment and during follow-up

Results

The analysis of the data showed that 64% of patients (19/30) experienced improved or good results in incontinence after undergoing urotherapy. Children with classic bladder exstrophy had a higher success rate, and achieved a good or improved result (11/14; 79%), compared to children with epispadias (7/15; 47%). The only patient with cloacal exstrophy that was enrolled completed treatment with an improved result. Among the patients with persistent incontinence complaints, 67% (8/12) reported that the complaints were socially acceptable at the end of follow-up.

Conclusion

The outcomes of our study reveal that 64% of BEEC patients who participated in our urotherapy program for persistent incontinence after reconstructive surgery achieved either complete continence or showed improvement in their condition. Additionally 67% of patients who did not achieve complete continence reported that the remaining incontinence was manageable at the end of the follow-up period. These findings strongly advocate counselling patients with BEEC to consider exploring more conservative treatment options before opting for further surgery.