title: Continence in bladder exstrophy: determinants of success.
abstract: We evaluated 19 female and 18 male patients with bladder exstrophy, who had completed staged reconstruction, had required no further surgery and underwent urodynamic studies. Of the male population 61% were continent based on a significantly higher urethral continence length (25.8 +/- 6.4 mm., mean plus or minus standard error) and a higher urethral closing pressure (69.4 +/- 5.8 cm. water) compared to the incontinent male population (11.4 +/- 3.1 mm. and 43.4 +/- 4.6 cm. water). No significant difference was noted in the bladder capacity of these 2 groups. Of the female population 57.9% were continent. They also demonstrated a higher urethral continence length (21.1 +/- 4.4 mm.) and a higher urethral closing pressure (62.7 +/- 10.2 cm. water) compared to the incontinent female subjects (8.4 +/- 2.5 mm. and 32.7 +/- 6.9 cm. water). Moreover, those who were continent had a significantly higher bladder capacity (201.2 +/- 39.5 ml.) compared to those who were incontinent (84.3 +/- 23.6 ml.). These findings support a multifactorial mechanism in achieving continence but they suggest that of all the factors urethral length may be the most important.
authors.affiliation: Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: P A
authors.initials: PA
authors.lastname: Merguerian
authors.forename: G A
authors.initials: GA
authors.lastname: McLorie
authors.forename: N D
authors.initials: ND
authors.lastname: McMullin
authors.forename: A E
authors.initials: AE
authors.lastname: Khoury
authors.forename: D A
authors.initials: DA
authors.lastname: Husmann
authors.forename: B M
authors.initials: BM
authors.lastname: Churchill
mesh_terms: D001746:Bladder Exstrophy / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D013997:Time Factors; D014521:Urethra / Q000503:physiopathology; D001743:Urinary Bladder / Q000503:physiopathology; D014549:Urinary Incontinence / Q000517:prevention & control*; D014563:Urodynamics / Q000502:physiology*