Definition:
Bladder exstrophy repair is surgery to repair a birth defect in which the bladder is inside out and sticks out of the abdominal wall. The pelvic bones are also separated.
Alternative Names:
Bladder birth defect repair; Everted bladder repair; Exposed bladder repair; Repair of bladder exstrophy
Description:
Bladder exstrophy repair involves two surgeries: One to repair the bladder and another to attach the pelvic bones to each other. The first surgery separates the exposed bladder from the abdomen wall and closes the bladder. The bladder neck and urethra are repaired. A flexible, hollow tube called a catheter is placed to drain urine from the bladder through the abdominal wall. A second catheter is left in the urethra to promote healing. The second surgery, pelvic bone surgery, may be done along with the bladder repair. Or, it may be delayed for weeks or months.
Why the Procedure Is Performed:
The surgery is recommended for children who are born with bladder exstrophy. Bladder exstrophy occurs more often in boys and is often associated with other birth defects. Surgery is necessary to: - Allow the child to develop normal urinary control
- Avoid future problems with sexual function
- Improve the child's physical appearance (genitals will look more normal)
- Prevent infection that could harm the kidneys
Sometimes the bladder is too small at birth, so the surgery will be delayed till the bladder has grown. In this case, the newborn is sent home on antibiotics and the bladder, which is outside the abdomen, must be kept moist. It can take months for the bladder to grow to the right size. The infant will be followed closely by a medical team to determine when the surgery should take place.
References:
Gearhart JP, Mathews R. Exstrophy-Epispadias Complex. In: Wein AJ, ed. Wein: Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 119. Hammer G, Hall S, Davis PJ. Anesthesia for general abdominal, thoracic, urologic, and bariatric surgery. In: Motoyama E, Davis P, eds. Smith’s Anesthesia for Infants and Children. 7th ed. Philadelphia, Pa: Mosby Saunders Elsevier; 2005:chap 19.
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