Urinary and fecal continence in adolescent and adult patients with cloacal exstrophy: urological congenitalism

Objective - To evaluate the prevalence of urinary (UI) and fecal incontinence (FI) and the incontinence-related quality of life (QoL) in adolescent and adult patients with cloacal exstrophy (CE) in Germany. - Patients and Methods - CE-patients of a tertiary care center and the German support group f...

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Hauptverfasser: Wenk, Maren (VerfasserIn) , Mühlbauer, Julia (VerfasserIn) , Schwarzer, Nicole (VerfasserIn) , Stein, Raimund (VerfasserIn) , Younsi, Nina (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: June 2022
In: Urology
Year: 2022, Jahrgang: 164, Pages: 293-299
ISSN:1527-9995
DOI:10.1016/j.urology.2022.01.009
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.urology.2022.01.009
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0090429522000231
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Verfasserangaben:Maren Himmler, Julia Mühlbauer, Nicole Schwarzer, Raimund Stein, and Nina Younsi

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520 |a Objective - To evaluate the prevalence of urinary (UI) and fecal incontinence (FI) and the incontinence-related quality of life (QoL) in adolescent and adult patients with cloacal exstrophy (CE) in Germany. - Patients and Methods - CE-patients of a tertiary care center and the German support group for anorectal malformations (SoMA e.V.) were included (October 2015 until September 2020). Data were assessed using a composed questionnaire consisting of 18 self-generated questions and two validated German questionnaires (King's health questionnaire, Questionnaire on Quality of Life in Fecal Incontinence (FLQAI)). - Results - Out of 23 included patients, 19 had continent and 3 incontinent urinary diversions (UD), 1 was unspecified; 2/23 were on dialysis. 73.7% (14/19) had undergone bladder augmentation, 4/19 had a pouch, 1/19 a neobladder. 94.7% (18/19) had a continent cutaneous channel and performed intermittent self-catheterization. UI was common (71.4%, 15/21). Neither the UD nor the involuntary loss of urine itself had a significant impact on QoL. Comparing the King's health questionnaire results, UI-related QoL of CE-patients was significantly lower than in a published reference group. 78.3% (18/23) had a bowel stoma. 34.8% (8/23) reported involuntary stool-soiling. Neither the way of bowel-emptying nor involuntary stool-soiling itself showed significant influence on FI-related QoL in the FLQAI. FLQAI items showed significant differences only for one of two published reference groups. - Conclusion - Long-term incontinence rates in adolescent and adult CE-patients are high. Incontinence-related QoL was reduced compared to published reference groups but was minimally influenced by incontinence itself, the type of UD or the way of bowel-emptying, respectively. 
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