title: Operative reconstruction of the external and internal genitalia in female patients with bladder exstrophy or incontinent epispadias.
abstract: OBJECTIVE
  Urologists and gynecologists rarely encounter questions on cohabitation and pregnancy in female patients with bladder exstrophy or incontinent epispadias.
  
  
  METHODS
  Until 1994, 41 female patients underwent surgery at our institution (vaginal cutback or vaginoplasty in 23, correction of the external genitalia in 25 and uterus fixation to correct or prevent prolapse in 13).
  
  
  RESULTS
  Followup was available in 37 patients (mean 16.8 years, with followup of 18 years or longer in 19). Of the patients 94% are satisfied with the cosmetic results. All adults engage in sexual intercourse, 4 delivered 6 children by cesarean section and 5 presently desire children.
  
  
  CONCLUSIONS
  Fertility in patients with bladder exstrophy or incontinent epispadias is normal, and pregnancy is possible. Patients and parents should be well informed. Besides urinary tract reconstruction, correction of the external and internal genitalia should be discussed in detail.
authors.affiliation: Department of Urology, University of Mainz School of Medicine, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Stein
authors.forename: M
authors.initials: M
authors.lastname: Fisch
authors.forename: H
authors.initials: H
authors.lastname: Bauer
authors.forename: V
authors.initials: V
authors.lastname: Friedberg
authors.forename: R
authors.initials: R
authors.lastname: Hohenfellner
mesh_terms: D000293:Adolescent; D001746:Bladder Exstrophy / Q000601:surgery*; D002648:Child; D003075:Coitus; D004842:Epispadias / Q000601:surgery*; D005260:Female; D005298:Fertility; D005500:Follow-Up Studies; D005836:Genitalia, Female / Q000601:surgery*; D006801:Humans; D011247:Pregnancy; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000601:surgery*; D014599:Uterus / Q000601:surgery; D014621:Vagina / Q000601:surgery