Long-term follow up (37-69 years) of patients with bladder exstrophy treated with ureterosigmoidostomy: uro-nephrological outcome.
OBJECTIVE
To describe the urological and nephrological long-term outcome of patients born with classical bladder exstrophy treated with bilateral ureterosigmoidostomies in early childhood.


METHODS
Out of 42 patients born with bladder exstrophy in Switzerland between 1937 and 1968, 25 participated in this study; seven had died, seven were lost to follow up and three refused consent. Assessment included chart review, clinical examination, and assessment of renal function and morphology.


RESULTS
After a follow-up period of 37-69 years ((mean 50 years), 13 of the 25 participants (52%) had their ureterosigmoidostomy still in place. All others had different forms of urinary diversions. Fifteen (60%) patients had normal renal function or mild chronic kidney disease as assessed by estimated glomerular filtration rate. Three patients were on renal replacement therapy. MRI (n=16) showed 10 morphologically normal kidneys. One patient suffered from adenocarcinoma of the colon, five had benign colonic polyps, one urethral papillary carcinoma and 18 no evidence of tumor.


CONCLUSIONS
The majority of our patients have normal or mildly impaired renal function and a well functioning ureterosigmoidostomy. This is remarkable, given the fact that ureterosigmoidostomies are considered to be refluxing high-pressure reservoirs at risk of renal injury and malignancy.
Gobet
Rita
R
Division of Urology, University Children's Hospital Zurich, Steinwiestr. 75, 8032 Zurich, Switzerland. rita.gobet@kispi.uzh.ch
Weber
Daniel
D
Renzulli
Pietro
P
Kellenberger
Christian
C
D000230:Adenocarcinoma / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D001746:Bladder Exstrophy / Q000453:epidemiology* / Q000601:surgery*; D002291:Carcinoma, Papillary / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003110:Colonic Neoplasms / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014519:Ureterostomy; D014547:Urinary Diversion; D014549:Urinary Incontinence / Q000453:epidemiology; D014554:Urination; D052878:Urolithiasis / Q000453:epidemiology