Bladder exstrophy management at Tikur Anbesa University Hospital, Addis Ababa, Ethiopia.

BACKGROUND: Bladder exstrophy is a rare congenital malformation which presents a defect of anterior lower mid abdominal wall, with anteriorly deficient bladder wall, widening of symphysis pubis, and epispadias. Management includes single or multiple stage repairs and urinary diversion procedures aimed at preservation of renal function, maintenance of continence to urine, normal appearing external genitalia and satisfactory sexual function.

OBJECTIVE: To review the experience of Bladder extrophy management at Tikur Anbessa University Hospital, Addis Ababa, Ethiopia, in five years.

METHODS: Retrospective review of medical records of pediatric patients managed for bladder extrophy at Tikur Anbesa Hospital, Addis Ababa, Ethiopia from September 1st 2007 to August 31st 2012.

RESULTS: A total of forty six cases of classic bladder extrophy were seen and managed between September 1st, 2007 to August 31st, 2012. Thirty one (67.69%) of them were managed by staged repair and 15 (32.61%) were managed by diversion of urine to ureterosigmoidostomy pouch (Mainz II pouch). The results of staged repair on 31 cases (67.39%) were early to assess because most of them were waiting for second stage repair. Regarding those managed by Mainz II pouch ureterosigmoidostomy 14/15 (93.3%) achieved continence to urine which was satisfactory in terms of quality of life.

CONCLUSION: Ureterosigmoidostomy pouch is a good alternative for selected neglected cases in improving the quality of life in the developing world.