ABSTRACT This retrospective study examines the outcomes and follow-up of 45 patients with exstrophy–epispadias complex (EEC) treated at a single institution from September 2014 to December 2023. The cohort included 25 cases of bladder exstrophy (20 males and five females) and 26 cases of epispadias (19 males and seven females). Across the study period, 68 surgical procedures were performed, encompassing a range of complex cases, such as closed exstrophy with subsequent epispadias repair, a female reared as male until adulthood, and a male presenting with skin-covered exstrophy, diphallia, and lifelong incontinence. Primary bladder and abdominal closure was achieved in 25 patients, with a reclosure rate of 12%. One adult male underwent Mitrofanoff diversion, whereas a 19-year-old female required bladder augmentation and rectus flap interposition following initial closure. Male epispadias repair was conducted in 19 patients, resulting in a fistula rate of 15.7%. Seven females underwent epispadias repair, and bladder neck reconstruction was performed in seven cases, yielding a continence rate of 85.7%, including those who achieved social continence. The data demonstrate that EEC requires meticulous, staged surgical management, with ongoing follow-up from infancy through adulthood. The presentation of EEC in adulthood remains exceptional. Successful attainment of continence stands as the central objective in the management of this congenital anomaly, underscoring the importance of individualized treatment strategies and long-term care for optimal patient outcomes.
Arya et al. (2026) studied this question.