[Transition of adolescents with the exstrophy-epispadias complex to adult medicine: influence of long-term outcome results on management]

Klin Padiatr. 2012 Nov;224(7):455-60. doi: 10.1055/s-0032-1327731. Epub 2012 Nov 30.
[Article in German]


Today, young individuals with rare congenital anomalies as the Exstrophy-Epispadias-Complex (EEC) are mostly monitored interdisciplinary with a high standard of care and enthusiasm during childhood. However, when growing up through adolescence to adulthood adequate care-givers are not available at the moment in adult medicine in Germany and a concrete transition process has yet not been established. Over the past years, we put much effort in systematic evaluation of long-term outcome after reconstruction of the EEC in the newborn period to further improve outcome results. Beside predictive parameters for continence and long-term bladder function, genital function and fertility, as well as postoperative pelvic floor morphology and gynecological outcome, orthopedic results and psychosexual and psychosocial development in EEC were of major interest. As a consequence we currently develop a German-wide follow-up concept in EEC patients regarding age- and gender specific outcome issues. Long-term observations of the EEC outcome however, underline the unrestricted importance of careful long-term follow-up of all EEC patients, as well as the necessity of close cooperation of pediatric urologist, pediatric surgeons, urologists, orthopedic surgeons, gynecologists, andrologists, psychologists and urotherapists from early childhood and the need of knowledge transfer and hopefully a successful transition of the EEC individuals to general medicine.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Bladder Exstrophy / psychology
  • Bladder Exstrophy / surgery*
  • Body Image
  • Child
  • Child, Preschool
  • Cooperative Behavior*
  • Epispadias / psychology
  • Epispadias / surgery*
  • Female
  • Humans
  • Infant
  • Infertility, Female / etiology
  • Infertility, Female / psychology
  • Infertility, Male / etiology
  • Infertility, Male / psychology
  • Interdisciplinary Communication*
  • Longitudinal Studies
  • Male
  • Patient Care Team*
  • Penis / surgery
  • Pregnancy
  • Pregnancy Complications / etiology
  • Pregnancy Complications / psychology
  • Prognosis
  • Sperm Count
  • Transition to Adult Care*
  • Uterine Prolapse / etiology
  • Uterine Prolapse / psychology
  • Uterine Prolapse / surgery
  • Young Adult