Exstrophy of the Bladder

The author treated 101 male and 55 female patients who had various congenital defects of the urinary bladder. The defects ranged from mild forms and normal external genitalia to extreme forms and the absence of one or more essential structures, which made it exceedingly difficult for the surgeon to offer the patient any prospect of a socially normal life. Since 1950, ureterointestinal anastomosis and cystectomy have been performed during the first year of the patient's life. Of the 130 patients in this series who underwent ureterosigmoidostomy with cystectomy, 75 were not more than one year old; in the entire series there were six operative deaths (4.6%). Although serious complications after operation have been observed, 100 patients are alive from 1 to 29 years after operation, and valuable knowledge has been accumulated. Recently, ureteroileosigmoidostomy has given gratifying results; of 14 children treated, all but one survived.