Long-term urinary outcomes in classic bladder exstrophy: results of an extensive follow-up

IF 3.7 2区医学 Q1 UROLOGY & NEPHROLOGY

BJU International Pub Date : 2025-02-26 DOI:10.1111/bju.16680

Sarah Abdellaoui, Fabiana Cazzorla, Nicolas Morel-Journel, Valeska Bidault, Paul Neuville, Alain Ruffion, Pierre D.E. Mouriquand, Delphine Demède

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引用次数: 0

Abstract

Objectives

To evaluate long-term outcomes and predictive factors of urinary continence (UC) and fecal continence (FC) after surgery for classic bladder exstrophy (CBE) using validated questionnaires.

Patients and Methods

This study is part of the QUALEXSTRO study, a retrospective, observational, single-centre cohort study assessing through questionnaires UC, FC, sexuality, fertility, and quality of life in patients treated for CBE, who were aged of at least 15 years at evaluation. Herein, UC and FC were assessed using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) and the Fecal Incontinence Quality of Life Scale (FIQL), respectively.

Results

Of the 63 eligible patients, 42 patients responded to the study (response rate 66.7%). Most patients were treated using the modern staged repair exstrophy technique (88.1%) with pelvic osteotomy (95.2%). A total of 69% of patients underwent continent urinary diversion, 61.9% underwent augmentation enterocystoplasty (AEC), and 7.1% underwent bladder neck closure. Additional endourological procedures were performed in 45.2% of patients. The median (interquartile range [IQR]) age and follow-up were 26 (18–35) years and 22 (17–32) years, respectively. Regarding the voiding mode, 21.4% of patients were able to void spontaneously per urethra without intermittent catheterisation, while 76.2% performed clean intermittent self-catheterisation (CISC). All patients who underwent AEC performed intermittent catheterisation. The median (IQR) ICIQ-UI SF score was 8 (0–13) and was significantly better in women (P = 0.002). A total of 13 patients (30.9%) were continent (ICIQ-UI SF score = 0). Of these, three were able to void spontaneously per urethra, 10 used CISC, and seven underwent AEC. Most patients (66.7%) did not respond to the FIQL questionnaire since they had no concerns regarding FC.

Conclusions

Achieving UC depends on both initial and subsequent surgeries, with few patients able to void per urethra during adulthood. Women have better urinary outcomes than men.

Abstract Image

查看原文本刊更多论文

经典膀胱外翻的长期泌尿结局：广泛随访的结果。

目的：采用有效的问卷调查方法，评估经典膀胱外泄（CBE）术后尿失禁（UC）和大便失禁（FC）的长期预后和预测因素。患者和方法：本研究是QUALEXSTRO研究的一部分，该研究是一项回顾性、观察性、单中心队列研究，通过问卷调查评估接受CBE治疗的患者的UC、FC、性、生育能力和生活质量，评估时年龄至少为15岁。本研究中，UC和FC分别采用国际失禁咨询问卷-尿失禁简表（ICIQ-UI SF）和大便失禁生活质量量表（FIQL）进行评估。结果：在63例符合条件的患者中，42例患者对研究有反应（有效率66.7%）。大多数患者采用现代分期修复外翻技术（88.1%）联合骨盆截骨术（95.2%）治疗。共有69%的患者接受了尿潴留，61.9%的患者接受了肠囊增强成形术（AEC）， 7.1%的患者接受了膀胱颈闭合。45.2%的患者接受了额外的泌尿外科手术。年龄和随访时间的中位数（四分位间距[IQR]）分别为26（18-35）岁和22（17-32）岁。在排尿方式方面，21.4%的患者能够在不间断导尿的情况下自行排尿，76.2%的患者进行了清洁的间歇自导尿（CISC）。所有接受AEC的患者都进行了间歇导尿。ICIQ-UI SF评分中位数（IQR）为8分（0-13分），女性明显更好（P = 0.002）。大陆13例（30.9%）（ICIQ-UI SF评分= 0）。其中，3人能够自发地通过尿道排空，10人使用CISC， 7人接受AEC。大多数患者（66.7%）没有对FIQL问卷做出反应，因为他们不担心FC。结论：UC的实现取决于最初和随后的手术，很少有患者在成年期能够通过尿道排空。女性的泌尿系统状况比男性好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BJU International 医学-泌尿学与肾脏学

CiteScore

9.10

自引率

4.40%

发文量

262

审稿时长

1 months

期刊介绍： BJUI is one of the most highly respected medical journals in the world, with a truly international range of published papers and appeal. Every issue gives invaluable practical information in the form of original articles, reviews, comments, surgical education articles, and translational science articles in the field of urology. BJUI employs topical sections, and is in full colour, making it easier to browse or search for something specific.