title: The patient with exstrophy in adult life.
abstract: 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.
mesh_terms: D000293:Adolescent; D000328:Adult; D001746:Bladder Exstrophy / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology; D008297:Male; D011247:Pregnancy; D011788:Quality of Life; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D001743:Urinary Bladder / Q000601:surgery