Bladder exstrophy is an infrequent congenital defect in which bladder grows outside the fetus. Outside growth of bladder resulted in urinary incontinence and malfunctioning bladder.
Bladder exstrophy-epispadias complex (BEEC) is a larger group of bladder defect resulting congenital defects. Bladder exstrophy is the most common in those complex diseases. One of the following condition can result if a child has BEEC
- Epispadias is the least severe form in which urethra is not formed properly
- Children’s affected with bladder extrophy has vesicoureteral reflux. Most of the children have coexisting epispadias.
- Cloacal exstrophy which is the most severe form of BEEC. In this the fetus body has joint rectum, bladder and genitals. Pelvic bones are also affected. Children born with cloacal exstrophy have also spinal deformities spina bifida.
Exact cause of bladder exstrophy is not known. However,
researchers think that it is due to combination of genetic
and environmental factors affecting the cloaca from which
reproductive and urinary tract organs are formed.
Complications of bladder exstrophy depend on fact that surgery is done or not.
- Without surgery bladder exstrophy can lead to persistent urinary incontinence and sometimes bladder cancer and sexual dysfunction.
- After surgery the risk of complications are greatly reduced but pregnancy may be considered with great care.
Diagnosis of bladder exstrophy is incidental during routine pregnancy ultrasound. It can be diagnosed more precisely by MRI. After birth doctor check by different criteria the extent of bladder extrophy like area of bladder exposed, presence or absence of inguinal hernia, position of opening of anus etc.
The only treatment of this condition is the reconstructive surgery. Two types of surgical repairs are considered:
- Complete repair
- Staged repair
After surgery surgical followups including pain management and immobilization is done.