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S26-5
(PP)
THE PATIENT REPORTED IMPACT OF PELVIC ORGAN PROLAPSE ON CONTINENCE
AND SEXUAL FUNCTION IN WOMEN WITH EXSTROPHY-EPISPADIAS COMPLEX
Ross EVERETT, Sunil REDDY, Brian INOUYE, Heather DICARLO, Ezekiel YOUNG, Mahmoud ABDELWAHAB and John
GEARHART
The Johns Hopkins University School of Medicine, James Buchanan Brady Urological Institute, Baltimore, USA
PURPOSE
Bladder exstrophy is a major congenital anomaly that involves pelvic deformities and abnormal pelvic floor musculature,
resulting in a “box-like, open book” pelvis with an anteriorly positioned bladder. The authors reviewed long-term
urogynecologic issues faced by adult women born with exstrophy-epispadias complex (EEC) that developed pelvic organ
prolapse (POP).
MATERIAL AND METHODS
The authors retrospectively reviewed medical records of identified patients. Information regarding sexual function,
continence status, and quality of life was assessed through surveys, including the POP-Urinary Incontinence Sexual
Questionnaire (PISQ-12) and the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short
Form (ICIQ-UI SF). Highers scores indicated higher function/
RESULTS
Eleven patients (46%) of 24 identified patients, ages 21 to 54 years old, 10 with Classic Bladder Exstrophy and 1 with
cloacal exstrophy, completed surveys. Patients underwent first correction of POP at a median age of 19.5 (6-46)
years and median time since correction was 7.5 (6-18) years. Eight (73%) patients reported reductions in quality of life
resulting from incontinence. Correction of POP improved mean ICIQ-UI SF (0-21) from 18.3 to 7.0, with a lower score
indicating better function. Sexual function was assessed for the time period prior to correction of prolapse as well as the
most recent six months. Seven (64%) of our patients were sexually active prior to prolapse surgery. For those seven,
mean PISQ-12 scores for the Behavioral-Emotive Domain and Physical Domain were 7.5 and 11.2, respectively.
Following correction of prolapse, mean scores for the Behavioral Domain and Physical Domain were 5.40 and 3.10,
representing improvements in both areas. The mean total PISQ-12 score (0-48) before correction of POP was 21 which
improved to 10.4 post-operatively.
CONCLUSIONS
Identification and correction of pelvic organ prolapse may offer notable improvements in the lives of adult female EEC
patients.