Psychiatric morbidity in bladder exstrophy-epispadias complex: A systematic review with a population-based case-control study
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https://creativecommons.org/licenses/by/4.0/
Lataukset19
Pysyvä osoite
Kuvaus
© 2026 The Author(s). Published by Elsevier Ltd on behalf of Journal of Pediatric Urology Company. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Introduction
Bladder exstrophy and epispadias complex is a rare congenital anomaly with significant medical and psychosocial implications. We employed a dual approach to evaluate the prevalence and risk factors of psychiatric morbidity in bladder exstrophy and epispadias patients, by combining a systematic review with a retrospective national registry study.
Objective
To evaluate the prevalence and risk factors of psychiatric morbidity in bladder exstrophy and epispadias complex.
Methods
We conducted a systematic literature review following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, including studies on psychiatric disorders or symptoms and quality of life in bladder exstrophy and epispadias patients of all ages. Article quality was assessed using the Newcastle–Ottawa Scale. Prevalence data for psychiatric conditions and scores from psychiatric and quality-of-life questionnaires were extracted.
Additionally, all bladder exstrophy and epispadias patients born in Finland 2001–2006 were identified from national registries. A matched and randomized control group without congenital malformations was selected from the same population. We evaluated the prevalence and risk factors for psychiatric diagnoses in this cohort.
Results
Of the 3850 retrieved results, 30 studies with 1179 participants were included. The overall prevalence of psychiatric morbidity was 31 %, [95 % CI 17 %–47 %]. Psychiatric morbidity was highest in adolescents, while morbidity in adults was comparable to the general population.
In the Finnish cohort, 80 % (n = 16/20) of bladder exstrophy and epispadias patients had a psychiatric diagnosis compared to 26 % (n = 21/80) of the controls (OR 11.2, [95 % CI 3.37–37.4], p < 0.001). The severity of the anomaly, number of surgeries, maternal unemployment, or maternal psychiatric diagnosis were not significantly associated with increased psychiatric morbidity.
Conclusions
Bladder exstrophy and epispadias is associated with an elevated risk of psychiatric morbidity. Our dual approach highlights the need for systematic mental health assessment and support in this population.
Emojulkaisu
ISBN
ISSN
1873-4898
1477-5131
1477-5131
Aihealue
Kausijulkaisu
Journal of pediatric urology|22
OKM-julkaisutyyppi
A2 Katsausartikkeli tieteellisessä aikakauslehdessä (vertaisarvioitu)