Long-term orthopedic outcomes in patients with epispadias and bladder exstrophy

Background/purpose: The aim of the study was to explore long-term orthopedic outcomes in patients with epispadias and bladder exstrophy (BE). Methods: Sixty-three adult patients with epispadias or BE were mailed the Modified Nordic Musculoskeletal Questionnaire, of which 33 (52%) responded. The patients were reviewed for possible pain in the lower back, hips, knees, and ankles, and their physical activity was scored, and the effect of possible pelvic osteotomy at the time of primary closure among patients with BE was evaluated. Results: Patients with BE had more low-back pain during the last 12 months compared with patients with epispadias (84%/43%, P < .05). In terms of physical activity, the ability to run continuously without stopping was significantly reduced in patients with BE (P < .05). Patients with BE, especially women, who underwent pelvic osteotomy suffered more from hip pain compared with patients without pelvic osteotomy (45%/0%, P < .05). Conclusions: Patients with BE suffer more from low-back pain and have decreased running performance compared with patients with epispadias. Although pelvic osteotomy is widely used to achieve tension-free primary closure of abdominal wall, patients with osteotomy suffered more from hip pains, suggesting that pelvic osteotomy is indicated mainly when primary closure either is impossible or fails in BE reconstruction. (C) 2012 Elsevier Inc. All rights reserved.