MP18-17: Magnetic Resonance Imaging of the Bladder, Prostate, Penile Vasculature and Pelvic Floor Muscles Anatomy in Adult Men after Childhood Bladder Exstrophy-Epispadias Complex Repair
Introduction: The musculoskeletal defects in lower abdomen and pelvis and genitourinary defects associated with bladder exstrophy-epispadias complex (BEEC) may result in variations in the anatomy of pelvic floor musculature and pelvic organs, which may affect the urinary continence and sexual function of BEEC patients following primary repair. Therefore, we evaluated the anatomy of bladder, prostate, penile vasculature and pelvic floor muscles of adult men who had experienced BEEC repair using a 3-Tesla pelvic magnetic resonance imaging (MRI). Methods: In a retrospective study, we reviewed the database of the post pubertal male patients who underwent repair of BEEC at our tertiary center from 1990 till 2006. Those patients were invited to undergo a 3-Tesla pelvic MRI to delineate the pelvic anatomy after the multiple reconstructive surgeries that might compromise the neurovascular supply of the pelvic organs and affect the pelvic musculature. Results: A total of 21 male patients with mean ages 21.7 ± 5.2 years old, were included. Seven patients underwent repair as a primary procedure, while 14 patients had redo procedures. Coronal images of pelvic MRI showed bladder neck to erectile body distance, iliococcygeal angle, prostate diameter, corpus cavernosum diameter, inter-corporeal diameter, neurovascular bundle, penile vasculature and length, symmetry between both corporeal bodies and depth of bladder neck from anterior skin (Table 1). Axial images revealed iliac, ischial, obturator internus and puborectalis angles, posterior anal distance, bladder neck distance, anteroposterior diameter of the prostate, symphyseal and erectile diastasis distance, while sagittal images showed sacral anal and sacral bladder neck angles (Table 2). Conclusions: MRI can accurately outline the anatomy of the pelvic organs, neurovascular bundles and pelvic musculature in adult men who had undergone BEEC repair, so it may reflect the urinary continence and sexual function of those patients. SOURCE OF Funding: None
