87 / 330
87
19–22 APRIL, 2017, BARCELONA, SPAIN
RESULTS
Thirty patients were identified as having Cloacal Exstrophy over the period evaluated. An attempt
at creating a continent urinary reservoir was undertaken in 27. Four of the patients experienced
significant decline in their baseline renal function following reconstruction (2 renal transplants;
2 ESKD V) while one patient died of hepatic failure. Twenty patients had complete documentation
of their surgical history. Follow up ranged from 1-24 years (mean 10.4 years). Patients within this
group underwent a total of 302 surgeries resulting in an average of one operation per year of follow
up. Urinary tract procedures accounted for 101 (33%) of these procedures.
CONCLUSIONS
The goal of achieving urinary continence in cloacal exstrophy results in significant clinical morbidity
in the majority of patients. Initial management with an incontinent strategy (e.g. Ileal chimney, ileal
loop, delayed continent reconstruction) may prove to be a safer option in children with this complex
urinary anomaly.