Long-term followup after exstrophy closure: late improvement and good quality of life.

Now that we have observed the growth and development of 17 of our anatomically reconstructed exstrophy patients through 20 or more years of followup, we are convinced that reconstruction should be the preferred primary treatment. Most of these patients are healthy, attractive, well educated adults and have achieved emotional maturity and stability, despite their many problems. Anatomical reconstruction also has considerable advantages over other current treatments for exstrophy that were not apparent initially.

Management of urinary incontinence with electronic stimulation: observations and results.

The evolution in the management of urinary incontinence with electronic stimulation of the pelvic floor is reviewed. The effect of stimulation is analyzed. Our methods of candidate screening and the contraindications to treatment are discussed. Forty patients were treated for 2 to 15 months. Sixteen patients were post-prostatectomy, 4 had stress incontinence, 4 had upper motor neuron lesions, 1 was incontinent after repair of a rectovesical fistula and 15 were post-bladder exstrophy closure. The success rate in the first group was 45.4 per cent, in the second group 100 per cent, in the third group 50 per cent, in the fourth group 100 per cent and in the fifth group 27.2 per cent. In view of the method having been tried on cases resistant to other forms of treatment the results were encouraging. The most satisfying results were in the post-exstrophy group in which no response was expected.