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CC BY-NC-ND 4.0 · Revista Urología Colombiana / Colombian Urology Journal 2018; 27(01): 097-104
DOI: 10.1016/j.uroco.2017.02.003
Original Article | Artículo Original
Sociedad Colombiana de Urología. Publicado por Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Experiencia en el abordaje de pacientes con complejo extrofia-epispadias en un centro de alto nivel de complejidad en Colombia, 10 años

10-years experience in the management of bladder exstrophy-epispadias complex in a tertiary care health centre in Colombia
Juliana Arenas Hoyos
1   Estudiante de Medicina, quinto año, División de Investigación en Urología y Genética, Departamento de Urología, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
,
Adriana Marcela Pedraza Bermeo
2   Residente de Urología, tercer año, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia
,
Jaime Francisco Pérez Niño
3   Especialista en Urología, jefe del Departamento de Urología, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio-Fundación Santa Fe de Bogotá, Bogotá, Colombia
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Further Information

Publication History

02 November 2016

09 February 2017

Publication Date:
10 January 2018 (online)

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Resumen

Objetivos El complejo extrofia-epispadias (CEE) se considera una de las malformaciones más severas de la línea media de compromiso multisistémico. La extrofia vesical es la presentación más frecuente en el espectro del complejo. Esta patología tiene un alto impacto en la calidad de vida. A pesar de la relación entre un cierre primario temprano y mejores resultados, en nuestro medio la remisión es tardía y la experiencia es escasa. El objetivo del siguiente estudio es mostrar la experiencia en el abordaje de CEE en los últimos 10 años en una institución de alto nivel de complejidad y remisión en Colombia.

Materiales y métodos Se realiza un estudio observacional descriptivo, con una serie de casos del 2006 al 2016.

Resultados En 10 años, se presentaron 5 casos de CEE en un centro de alta complejidad y remisión en Colombia. La mayoría de los pacientes han tenido múltiples intervenciones; la edad del primer procedimiento fue 829 días en promedio (27,6 meses). Se ha tenido un seguimiento postoperatorio promedio de 2,8 años. No se han presentado neoplasias en el seguimiento. Las comorbilidades más frecuentes son infección y litiasis. Ninguno de los pacientes contactados reportó inicio de vida sexual. La escala International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI-SF) tuvo un promedio de 9 puntos. Existen factores sociales asociados en nuestro medio.

Conclusión El CEE requiere un abordaje temprano y multidisciplinario en instituciones con experiencia; los resultados en continencia urinaria, función sexual, desarrollo psicosocial y calidad de vida están sujetos a tratamiento oportuno de la patología.

Abstract

Objective Exstrophy-epispadias complex (ECC) is considered one of the most severe midline abnormalities. Exstrophy of the bladder is the most frequent presentation of the exstrophy-epispadias spectrum.

The disease has high impact on the quality of life. In developing countries, patient referral to experienced centres is often delayed. The experience in the disease is generally poor. The aim of this study is to describe the experience in the approach to EEC in the past 10 years in an institution of high level of complexity in Colombia.

Materials and methods An observational descriptive study of a case series.

Results A total of 5 cases of ECC were identified in the last 10 years in an institution of high level of complexity in Colombia. All the patients had multiple interventions. The mean follow-up time was 2.8 years. No neoplasms were recognised. The most common comorbidities were lithiasis and urinary tract infections. None of the patients contacted reported starting a sex life. The International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UC-SF) gave a mean of 9 points.

Conclusion The EEC requires an early and cross-disciplinary assessment in experienced centres. There are additional factors associated with the prognosis in our area.

Palabras Clave

extrofia vesical - complejo extrofia vesical y epispadias - cirugía - rehabilitación - calidad de vida - manejo de caso

Keywords

bladder exstrophy - complex Bladder exstrophy and epispadias - surgery - rehabilitation - quality of life - case management
 

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