Pelvic Organ Prolapse and Pregnancy in the Female Bladder Exstrophy Patient

Curr Urol Rep. 2018 Feb 26;19(3):18. doi: 10.1007/s11934-018-0767-2.


Purpose of review: Classic bladder exstrophy (BE) remains one of the most demanding reconstructive challenges encountered in urology. In female BE patients, the long-term sequela of both primary and revision genitoplasty, as well as intrinsic pelvic floor deficits, predispose adult women to significant issues with sexual function, pelvic organ prolapse (POP), and complexities with reproductive health.

Recent findings: Contemporary data suggest 30-50% of women with BE develop prolapse at a mean age of 16 years. Most women will require revision genitoplasty for successful sexual function, although in some series over 40% report dyspareunia. Current management for pregnancy includes elective cesarean section with involvement of high-risk obstetrics and urologic surgery. This review encapsulates contemporary concepts of etiology, prevalence, and management of POP and pregnancy in the adult female BE patient.

Keywords: Bladder exstrophy; Pelvic organ prolapse; Pregnancy; Urinary diversion.

Publication types

  • Review

MeSH terms

  • Bladder Exstrophy / complications*
  • Bladder Exstrophy / surgery
  • Cesarean Section
  • Delivery, Obstetric
  • Female
  • Female Urogenital Diseases / congenital
  • Female Urogenital Diseases / surgery
  • Fertility
  • Genital Diseases, Female / congenital
  • Genital Diseases, Female / surgery
  • Genitalia, Female / abnormalities
  • Genitalia, Female / surgery
  • Humans
  • Pelvic Floor / abnormalities
  • Pelvic Floor / surgery
  • Pelvic Organ Prolapse / etiology
  • Pelvic Organ Prolapse / therapy*
  • Plastic Surgery Procedures*
  • Pregnancy
  • Pregnancy Complications / etiology
  • Pregnancy Complications / therapy*
  • Pregnancy, High-Risk
  • Prevalence
  • Reoperation
  • Sexual Dysfunction, Physiological / surgery
  • Urinary Diversion
  • Urinary Tract Infections / etiology
  • Urogenital Abnormalities / surgery
  • Urologic Surgical Procedures