THE OUTCOME OF PATIENTS WITH CLASSIC BLADDER EXSTROPHY IN ADULT LIFE

Purpose: We determined the outcome of 20 adult bladder exstrophy patie nts regarding urinary continence, sexual function, fertility and psych osocial integration. Materials and Methods: A total of 16 men and 4 wo men completed an anonymous questionnaire and the charts were reviewed for medical history. Results: Of 9 patients who void spontaneously 6 a re dry for 4 hours and 3 for 2 hours. Among the remaining 11 patients 5 are dry on clean intermittent catheterization, 3 who had undergone u reterosigmoidostomy are dry for more than 4 hours and 3 had an inconti nent stoma. Four men and 2 women are married, including 2 men and 1 wo man who had a total of 7 children. Ten of 16 men (63%) reported that t hey ejaculate a few cubic centimeters in volume, 3 ejaculate only a fe w drops and 3 have no ejaculation (2 of whom underwent cystectomy). Se men was analyzed in 4 patients (3 with azoospermia and 1 with oligospe rmia) and average volume of ejaculate was 0.4 cc (range 0.2 to 1). All women reported regular and normal menstrual periods. A total of 15 pa tients experienced normal erections that were described as satisfactor y by 8 and not satisfactory by 6 due to a small penis, with dorsal cho rdee in 1. Of the 16 men 12 (75%) experienced satisfactory orgasms whi le 10 had participated in sexual intercourse with complete partner sat isfaction in 9. Half of the men and all women describe intimate relati onships as serious and long term. Of the 20 patients 15 (75%) achieved a high level of education. Conclusions: Bladder exstrophy patients ge nerally achieve good results but the fertility of most men is in doubt .