title: Quality of life in young adult patients treated for bladder exstrophy.
abstract: BACKGROUND
  Bladder exstrophy (BE) is a rare condition that requires complex surgical corrections to achieve the goals of bladder functionality, normal sexual function, continence, and finally cosmesis. The purpose of this study was to identify clinical parameters that predict better quality of life (QOL) scores using a validated questionnaire (SF-36) with young adults after completing surgical reconstruction.
  
  
  METHODS
  Forty-three young adults (mean age 22.35 years, 29 men and 14 women) treated for BE were evaluated using the Short Form 36 general health questionnaire (SF-36). Clinical assessment involved evaluation of the actual condition regarding continence, sexual function, genital satisfaction and overall cosmesis.
  
  
  RESULTS
  Both genders presented similar QOL scores (p = 0.36). The QOL was not age-related (p = 0.63). Neither genders did not present any differences in the number of procedures (p = 0.27). Although no significant gender difference was found, clinical impairments - such as urinary fistula, incontinence, penile length and infertility - were associated with worse QOL scores and were male-related (p <0.01). The most common complaint after complete surgical repair was about penile length (26/29 patients, 89.6%).
  
  
  CONCLUSIONS
  Age and gender were not predictors of better QOL scores. Any clinical impairment, such as urinary leakage due to incontinence or fistula, penile length and infertility, tended to significantly decrease the overall QOL in male patients with BE. The male genitalia seems to be the most troublesome aspect post-adolescence in treated male patients with exstrophy-epispadias. It has an important impact on the overall QOL, mainly having a social affect on those patients.
authors.affiliation: Center of Robotic Surgery, German Hospital Oswaldo Cruz, Sao Paulo, Brazil.
authors.forename: Jose Arnaldo Shiomi
authors.initials: JA
authors.lastname: da Cruz
authors.affiliation: Laboratory of Medical Research, Urology - LIM 55, University of Sao Paulo, Department of Urology, Sao Paulo, Brazil.
authors.forename: Bruno
authors.initials: B
authors.lastname: de Mattos
authors.affiliation: Laboratory of Medical Research, Urology - LIM 55, University of Sao Paulo, Department of Urology, Sao Paulo, Brazil.
authors.forename: Miguel
authors.initials: M
authors.lastname: Srougi
authors.affiliation: Cardon Children Medical Center, Arizona, United States.
authors.forename: Hiep
authors.initials: H
authors.lastname: Nguyen
authors.affiliation: Laboratory of Medical Research, Urology - LIM 55, University of Sao Paulo, Department of Urology, Sao Paulo, Brazil.
authors.forename: Rafael
authors.initials: R
authors.lastname: Bonan
authors.affiliation: Laboratory of Medical Research, Urology - LIM 55, University of Sao Paulo, Department of Urology, Sao Paulo, Brazil.
authors.forename: Francisco
authors.initials: F
authors.lastname: Denes
authors.affiliation: Center of Robotic Surgery, German Hospital Oswaldo Cruz, Sao Paulo, Brazil.
authors.forename: Amilcar
authors.initials: A
authors.lastname: Giron
authors.affiliation: Center of Robotic Surgery, German Hospital Oswaldo Cruz, Sao Paulo, Brazil.
authors.forename: Carlo
authors.initials: C
authors.lastname: Passerotti
keywords: bladder exstrophy; quality of life