• Manzoor Hussain, Usman Qamar, Saeed Abidi, Tanzeel Guzdar, Quratul Ain Ghori, and Syed Adibul Hasan Rizvi.
• Department of Urology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.
• J Coll Physicians Surg Pak. 2021 Oct 1; 31 (10): 1191-1195.

ObjectiveTo evaluate surgical outcomes and renal functions after cystectomy + MAINZ Pouch II and epispadias repair as a staged procedure in adult patients with exstrophy epispadias complex (EEC).Study DesignDescriptive study.Place And Duration Of StudyDepartment of Urology, Sindh Institute of Urology and Transplantation (SIUT), Karachi, from January 2004 to December 2020.MethodologyA total of 33 patients with EEC were treated. Out of which, 20 underwent cystectomy + MAINZ Pouch II with epispadias repair as a staged procedure. Out of these, 17 had a follow-up period of more than a year and were included in the study. The patients were followed up after 6 weeks of surgery, at 6 months, one year, and at the end of follow-up. The assessed variables included the patients' renal function tests, malignancy potential, morning erections, ejaculations, night emissions, day-and-night-time urinary frequency, and overall happiness of patients at the end of follow-up.ResultsThe mean age was 25.1 ± 7.5 years and mean follow-up duration was 7.8 ± 5.2 years. Postoperatively, there was a rise in blood urea from 27.8 to 35.08 mg/dl with a concurrent fall in serum bicarbonate from a mean of 23.5 to 20.2 mEq/dl. All patients were continent during the day-time postoperatively; whereas, two patients experienced nocturnal enuresis. All male patients exhibited good erections and ejaculations, but there was persistence of dorsal chordae in 4 (23.3%) patients. All were delighted, happy and pleased with the surgical outcomes and had returned to normal life. No rectal or sigmoid malignancy was observed.ConclusionIn adult EEC patients, cystectomy + MAINZ Pouch II and epispadias repair is safe and effective. Key Words: Adults, Exstrophy epispadias complex, MAINZ pouch II, Pakistan.

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