{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:29:27Z","timestamp":1786649367047,"version":"build-2736575974"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>This study evaluated the long-term risk of renal impairment and the factors influencing renal function after complete primary repair of classic bladder exstrophy (CBE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      A retrospective review was conducted for 66 patients with CBE (50 males, 16 females) who underwent complete primary repair between 1998 and 2024. The median follow-up time was 83.5 months (range, 12\u2013324 months). A\n                      <jats:italic toggle=\"yes\">post hoc<\/jats:italic>\n                      power analysis (\u03b1 =0.05,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 66, effect size = 0.5) showed a power of 0.98. The primary outcome was the estimated glomerular filtration rate (eGFR) at the final follow-up, with renal impairment defined as &lt; 60 mL\/min\/1.73 m\u00b2. Univariate and multivariate analyses assessed associations between renal impairment and key clinical factors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The median eGFR at the last follow-up was 112.4 mL\/min\/1.73 m\u00b2 (range 37.31\u2013147.7). Four patients (6.1%) developed renal impairment. Severe hydronephrosis (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.003), high-grade vesicoureteral reflux (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.003), febrile urinary tract infection (UTI) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.008), and smaller bladder capacity (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.032) were significantly associated with impaired renal function. Multivariate analysis identified severe hydronephrosis (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.025; odds ratio [OR] 33.8) and febrile UTI (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.033; OR 6.34) as independent predictors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Long-term renal function remained stable in most patients after complete primary repair of CBE, although 6% experienced renal impairment. Severe hydronephrosis, high-grade reflux, febrile UTI, and reduced bladder capacity were essential predictors, emphasizing the need for close monitoring and timely management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ua.ua_155_25","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T14:00:29Z","timestamp":1775829629000},"page":"179-185","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Long-term risk of renal impairment after complete primary repair of classic bladder exstrophy"],"prefix":"10.4103","volume":"18","author":[{"given":"Mohamed Emad","family":"Eldin","sequence":"first","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Assiut University, Asyut, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed A.","family":"Shahat","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Assiut University, Asyut, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed A.","family":"Elderwy","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Assiut University, Asyut, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaa E.","family":"Abdelmoneim","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Assiut University, Asyut, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"key":"R1-20260415","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1007\/s00345-006-0053-7","article-title":"Standing the test of time: Long-term outcome of reconstruction of the exstrophy bladder","volume":"24","author":"Woodhouse","year":"2006","journal-title":"World J Urol"},{"key":"R2-20260415","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.urology.2018.03.044","article-title":"Complete primary repair of bladder exstrophy: Critical analysis of the long-term outcome","volume":"117","author":"Arab","year":"2018","journal-title":"Urology"},{"key":"R3-20260415","doi-asserted-by":"crossref","first-page":"394.e1","DOI":"10.1016\/j.jpurol.2017.03.036","article-title":"Long-term fate of the upper tracts following complete primary repair of bladder exstrophy","volume":"13","author":"Ellison","year":"2017","journal-title":"J Pediatr Urol"},{"key":"R4-20260415","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1097\/JU.0000000000000505","article-title":"Urinary continence outcomes in classic bladder exstrophy: A long-term perspective","volume":"203","author":"Maruf","year":"2020","journal-title":"J Urol"},{"key":"R5-20260415","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.1016\/S0022-5347(01)64467-7","article-title":"Urolithiasis in the exstrophy-epispadias complex","volume":"158","author":"Silver","year":"1997","journal-title":"J Urol"},{"key":"R6-20260415","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1681\/ASN.2008030287","article-title":"New equations to estimate GFR in children with CKD","volume":"20","author":"Schwartz","year":"2009","journal-title":"J Am Soc Nephrol"},{"key":"R7-20260415","doi-asserted-by":"crossref","first-page":"235","DOI":"10.4055\/cios.2013.5.3.235","article-title":"How to calculate sample size and why","volume":"5","author":"Kim","year":"2013","journal-title":"Clin Orthop Surg"},{"key":"R8-20260415","doi-asserted-by":"crossref","first-page":"175","DOI":"10.3758\/BF03193146","article-title":"G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences","volume":"39","author":"Faul","year":"2007","journal-title":"Behav Res Methods"},{"key":"R9-20260415","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1007\/BF02012459","article-title":"Ultrasound grading of hydronephrosis: Introduction to the system used by the society for fetal urology","volume":"23","author":"Fernbach","year":"1993","journal-title":"Pediatr Radiol"},{"key":"R10-20260415","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/BF02388714","article-title":"International system of radiographic grading of vesicoureteric reflux. 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