Genital prolapse in adult women with classical bladder exstrophy

• Published in: International Urogynecology Journal Vol. 23; no. 9; pp. 1201 - 1205
• Main Authors: Nakhal, Rola S., Deans, Rebecca, Creighton, Sarah M., Wood, Dan, Woodhouse, Christopher R. J.
• Format: Journal Article
• Language: English
• Published: London Springer-Verlag 01.09.2012; Springer Nature B.V
• Subjects: Adolescent; Adult; Bladder Exstrophy - complications; Female; Follow-Up Studies; Gynecology; Humans; Medicine; Medicine & Public Health; Middle Aged; Pelvic Organ Prolapse - etiology; Pelvic Organ Prolapse - surgery; Polytetrafluoroethylene; Recurrence; Retrospective Studies; Surveys and Questionnaires; Treatment Outcome; Urinary Incontinence - etiology; Urology; Young Adult; Gore-Tex; Pelvic organ prolapse; Bladder exstrophy
• ISSN: 0937-3462; 1433-3023
• DOI: 10.1007/s00192-012-1717-z

Introduction and hypothesis The aim of this paper is to study the incidence and risk factors for genital prolapse in adult women with bladder exstrophy and to describe the long-term outcome of the Gore-Tex wrap procedure for genital prolapse. Methods A retrospective observational study on adult women with classical bladder exstrophy in a tertiary referral centre for disorders of sex development, including complex urogenital anomalies. Medical notes were reviewed and a confidential postal questionnaire on urinary continence and symptoms of prolapse was carried out. Results Fifty-two women with bladder exstrophy and a mean age of 39 years (range 23 to 63) were identified, of whom 27 patients (52%) developed pelvic organ prolapse. Twenty-three out of 27 (85%) were treated surgically while only 4 patients were managed expectantly. Risk factors for prolapse included pregnancy in 10 (37%) patients and introitoplasty in 1 patient (4%). Of the 23 women treated surgically, 16 (70%) were treated using a Gore-Tex wrap, while 7 had other surgical procedures including colposuspension and hysterosacrocolpopexy. In the Gore-Tex wrap group, 12 out of 16 patients (75%) had had a successful result after the first repair compared with 2 out of the 7 patients (28%) in the group treated using other procedures. Mean follow-up was 8 years (range 1–15). One patient developed an infection after the procedure and another patient had Gore-Tex erosion. Conclusions Prolapse is a common gynaecological complaint in adult women with bladder exstrophy and the majority will require treatment. At present the Gore-Tex wrap offers good results with a low rate of serious complications.