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Bladder exstrophy repair

Definition

  

Bladder exstrophy repair is a surgery to repair an uncommon birth defect in which the bladder is inside out and sticks out of the abdominal wall. The pelvic bones are also separated.

Bladder exstrophy occurs more often in boys and is often associated with other birth defects. Surgery to repair the defect is usually performed within the first 48 hours after birth.


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 have the pelvic bones attached to each other.

The first surgery separatesthe exposed bladder from the abdominal 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.


Indications

  

The surgery is recommended for children who are born with bladder exstrophy.


Risks

  

Risks specific to this procedure may include:

  • Chronic urinary tract infections
  • Inadequate urinary control (incontinence)
  • Need for future surgeries
  • Erectile/sexual dysfunction

Risks for any anesthesia are:

  • Breathing problems
  • Reactions to medications
Risks for any surgery are:
  • Bleeding
  • Infection

Expectations after surgery

  

Surgery is necessary to:

  • Prevent infection that could decrease kidney function
  • Allow the child to develop normal urinary control
  • Improve the child's physical appearance
  • Avoid future problems with sexual function
Some children are unable to develop adequate urinary control and may later need further urinary repair.

Convalescence

  

After pelvic bone surgery, the child will need to be in a lower body cast or sling, which helps the bones heal.

How long the child stays in the hospital depends on the severity of the bladder defect, the number of surgeries needed, and whether other medical problems exist.


 
Review Date: 11/2/2007
Reviewd By: Deirdre O’Reilly, M.D., M.P.H., Neonatologist, Division of Newborn Medicine, Children’s Hospital Boston and Instructor in Pediatrics, Harvard Medical School, Boston, Massachusetts.
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