Overview Of Bladder Exstrophy: A Third World Perspective

Main Category: Urology / Nephrology
Article Date: 02 Oct 2008 - 3:00 PDT

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UroToday.com - A study out of South Africa evaluated the group's experience with exstrophy in a Third World population. The group evaluated, in a retrospective manner, 57 patients managed between the years of 1983 and 2006. They reviewed social aspects, clinical findings, and short-term outcomes.

Of the 57 patients, 19 were born in metropolitan and 38 in rural hospitals. Twenty-four patients (42%) were referred on the first day of life, 21 (37%) within the first week, and 12 patients (21%) were greater than 1 week old. Associated congenital anomalies were seen in 18 patients (32%). Twelve patients died in hospital, and the remaining 45 were discharged home. They had follow-up data on 33 patients; their ages ranged from 2 to 17 years. On follow up, urinary incontinence was the main complaint and it was reported to have greatly affected the child's schooling and social well-being.

The group concluded that in their experience, bladder exstrophy is an uncommon condition and can have associated congenital abnormalities indicating a poor prognosis. I feel that their reported overall mortality rate of 42% is quite high. This is contrary to the typical experiences described here in the United States. Overall my impression from this paper really pushes my belief that exstrophy should be treated in specialized centers.

Wiersma R
J Pediatr Surg. 2008 Aug;43(8):1520-3.
doi:10.1016/j.jpedsurg.2007.11.005

Written by UroToday.com Medical Editor Pasquale Casale, MD

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