Abstract Book - 26th ESPU Congress, Joint Meeting with ICCS + SPU + AAP/SOU + AAPU + SFU

S26-15

(P)

CONGENITAL RENAL ANOMALIES IN CLOACAL EXSTROPHY: IS THERE A

DIFFERENCE?

Kristina SUSON

, Brian INOUYE

, Annelies CARL

and John GEARHART

1) Children's Hospital of Michigan, Pediatric Urology, Detroit, USA - 2) Johns Hopkins University School of Medicine,

Urology, Baltimore, USA - 3) Johns Hopkins University School of Medicine, Pediatric Urology, Baltimore, USA

PURPOSE

Patients with classic bladder exstrophy are at an increased risk of having congenital renal anomalies. We questioned the

incidence of renal anomalies in children with cloacal exstrophy.

MATERIAL AND METHODS

IRB-approved retrospective review of 112 patients with cloacal exstrophy. Data points included renal and Müllerian

anatomy. Abnormal renal anatomy was defined as a solitary kidney, malrotation, renal ectopia, congenital cysts,

duplication and/or proven obstruction. Abnormal Müllerian anatomy was defined as uterine or vaginal duplication,

obstruction, and/or absence. Statistical analysis included two-tailed Fisher's exact probability test.

RESULTS

Of 66 genetic males and 46 genetic females, complete data was available for 40 males and 35 females. Average age at

analysis was 18.6±1.29 years. Renal anomalies were identified in 48% of patients. They occurred more commonly in

males than females (60% of males vs 34.3% of females, p=0.037). Males were more likely to have a solitary kidney

than females (32.5% of males vs 8.6 % of females, p=0.022). Table 1 lists incidence of renal anomalies by genetic sex.

Multiple anomalies were identified in five patients, four of which had solitary kidneys. Female patients with renal

anomalies were significantly more likely to have abnormal Müllerian structures than those with two normal kidneys

(47.8% vs 8.3%, p=0.027).

Sex

Normal

Kidneys

Solitary

Kidney

Malrotated

Kidney

Ectopic

Kidney

Congenital

Cysts

Duplicated

Collecting System

UVJ Obstruction

XY 16

XX 23

UVJ = ureterovesical junction

CONCLUSIONS

Although renal anomalies are common in male and female patients with cloacal exstrophy, they seem to be more

prevalent in males. Female patients with aberrant renal anatomy are at a higher risk of Müllerian abnormalities.