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Epispadias and Incontinence: The Challenge of the Small Bladder

1988; Lippincott Williams & Wilkins; Volume: 140; Issue: 5 Part 2 Linguagem: Inglês

10.1016/s0022-5347(17)42001-5

1527-3792

Craig A. Peters, John P. Gearhart, Robert D. Jeffs,

Congenital Anomalies and Fetal Surgery

No AccessJournal of UrologyExstrophy and Epispadias1 Nov 1988Epispadias and Incontinence: The Challenge of the Small Bladder Craig A. Peters, John P. Gearhart, and Robert D. Jeffs Craig A. PetersCraig A. Peters , John P. GearhartJohn P. Gearhart , and Robert D. JeffsRobert D. Jeffs View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)42001-5AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail The 12-year experience at our hospital with epispadias and incontinence is reviewed and attention is focused on the approach to patients with a small bladder capacity. Of 29 children 20 had incontinence associated with the epispadias (13 boys and 7 girls). A total of 15 patients underwent definitive management of the incontinence with a Young-Dees bladder neck reconstruction with or without ureteral reimplantation and they are evaluable. Nine patients (6 boys and 3 girls) had a bladder capacity that was believed to be inadequate for satisfactory bladder neck reconstruction (less than 60ml.). To date, 7 of these children have undergone staged reconstruction with urethroplasty for epispadias as the initial operation. Bladder capacity increased 95ml. on the average (range 60 to 140ml.) after the urethroplasty. No child had hydronephrosis before or after bladder neck reconstruction. Review of the results of bladder neck reconstruction in all patients with a mean followup of 2.9 years (range 7 months to 13 years) demonstrates an 87 per cent satisfactory continence rate (9 of 9 boys and 4 of 6 girls). In the patients who underwent staged reconstruction the results were similar, with a 100 per cent continence rate in evaluable patients (5 of 5 boys and 2 of 2 girls). In conclusion, urethroplasty before bladder neck reconstruction in the epispadiac child with a small bladder allows an increase in capacity, thus, obviating for the most part the need for procedures such as bladder augmentation in the majority of these patients. © 1988 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByCheikhelard A, Aigrain Y, Lottmann H and Lortat-Jacob S (2009) Female Epispadias Management: Perineal Urethrocervicoplasty Versus Classical Young-Dees ProcedureJournal of Urology, VOL. 182, NO. 4S, (1807-1812), Online publication date: 1-Oct-2009.Gearhart J (2018) EDITORIAL: EVOLUTION OF EPISPADIAS REPAIR-TIMING, TECHNIQUES AND RESULTSJournal of Urology, VOL. 160, NO. 1, (177-178), Online publication date: 1-Jul-1998.MOLLARD P, BASSET T and MURE P (2018) MALE EPISPADIAS: EXPERIENCE WITH 45 CASESJournal of Urology, VOL. 160, NO. 1, (55-59), Online publication date: 1-Jul-1998.Diamond D and Ransley P (2018) Male EpispadiasJournal of Urology, VOL. 154, NO. 6, (2150-2155), Online publication date: 1-Dec-1995.Ben-Chaim J, Peppas D, Jeffs R and Gearhart J (2018) Complete Male Epispadias: Genital Reconstruction and Achieving ContinenceJournal of Urology, VOL. 153, NO. 5, (1665-1667), Online publication date: 1-May-1995.Gearhart J, Peppas D and Jeffs R (2018) Complete Genitourinary Reconstruction in Female EpispadiasJournal of Urology, VOL. 149, NO. 5 Part 1, (1110-1113), Online publication date: 1-May-1993.Perlmutter A, Weinstein M and Reitelman C (2018) Vesical Neck Reconstruction in Patients with Epispadias-Exstrophy ComplexJournal of Urology, VOL. 146, NO. 2 Part 2, (613-615), Online publication date: 1-Aug-1991.Gearhart J and Jeffs R (2018) Bladder Exstrophy: Increase in Capacity Following Epispadias RepairJournal of Urology, VOL. 142, NO. 2 Part 2, (525-526), Online publication date: 1-Aug-1989.Peters C and Hendren W (2018) Splitting the Pubis for Exposure in Difficult Reconstructions for IncontinenceJournal of Urology, VOL. 142, NO. 2 Part 2, (527-531), Online publication date: 1-Aug-1989. Volume 140Issue 5 Part 2November 1988Page: 1199-1201 Advertisement Copyright & Permissions© 1988 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Craig A. Peters More articles by this author John P. Gearhart More articles by this author Robert D. Jeffs More articles by this author Expand All Advertisement PDF DownloadLoading ...