The Patient with Exstrophy in Adult Life

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Abstract
Summary— One hundred and one cases of classical exstrophy with at least 18 years of follow‐up are reported. There were 29 girls and 72 boys. Nine have died but only 3 of urological causes; 19 have been lost to follow‐up at various times. In patients born before 1953 and in later patients with small bladders, primary diversion was done. In other patients primary closure was attempted with an 18% continence rate.Successful bladder closure produced a 25% incidence of any kind of renal damage. With diversion the incidence was 30% (colonic loop) and 75% (ileal loop).Sexual function is good. Six men have initiated pregnancies; 8 girls had 11 pregnancies, producing 9 normal children.Education, employment and family life have not been substantially affected.

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