BLADDER

EXSTROPHY
~By DIKSHA
TABLE OF CONTENTS
01 02 03

INTRODUCTION CAUSE DIAGNOSIS &

TEST

04 05 06

SYMPTOMS MANAGEMENT & COMPLICATIONS

RISK FACTORS
INTRODUCTION
Ø Bladder Exstrophy is a rare birth defect in which the
bladder develops outside the foetus. The exposed
bladder can’t store, urine or function normally resulting in
urine leakage (incontinence)
Ø It is characterised by the malformation of the lower
abdominal wall, bladder and urethra
Ø Problems caused by a Bladder Exstrophy vary in severity,
they can include defects in the bladder, genitals and
pelvic bones as well as defects in intestine and
reproductive organs
Ø It may be spotted on a routine ultrasound during
pregnancy. Sometimes do the defect isn’t visible until the
baby is born.
 Cause
v The exact cause of bladder exstrophy is not fully
understood, but it is believed to be a combination of
genetic and environmental factors. It is considered a
birth defect that occurs during early fetal
development.
v What is known is that as the foetus grows, a structure
called cloaca where reproductive ,urinary and
digestive openings all come together doesn’t develop
properly in babies who develop ladder exstrophy
defects in the cloaca can vary a lot depending on the
age of the foetus when the development error occurs.
 DIAGNOSE
PHYSICAL EXAMINATION
A visual inspection of the
newborns abdominal area is
usually the first step in
diagnosing bladder exstrophy.
The exposed bladder on the
outside of the abdomen is a
clear indicator of the
condition.
ULTRASOUND
it helps visualise a bladder
exstrophy and assess the
condition of the urinary tract
by using sound ways to create
picture of bladder and kidneys
X-RAYS
it may be taken to examine the
pelvic bone and assess their
alignment and shape.
Abnormalities in the pelvis are
commonly associated with
bladder exstrophy.
 SYMPTOMS
● The most apparent sign of the
Bladder Exstrophy is the visible
protrusion of the bladder through the
abdominal wall. Other associated
features may include an improperly
formed pelvis , urinary incontinence ,
pubic bone separation and genital
abnormalities in males
Epispadias
● This is the least severe form of
BEEC(Bladder Exstrophy-
Epispadias Complex) in which the
tube to expel urine or urethra
doesn’t fully develop
 SYMPTOMS
● The kidneys , backbone and spinal
cord also may be affected . Most
children with cloacal exstrophy have
spinal abnormalities, including spina
bifilar. Children born with protruding
abdominal organs probably also have
a cloacal exstrophy or bladder
exstrophy
Cloacal Exstrophy
● It is the most serious form of
BEEC. In this condition of the
rectum , bladder and the genital
don’t fully separate as the foetus
develop. These organs may not be
correctly formed and the pelvic
bone or affected as well.
 Risk factors
Family history:- firstborn children, children of a parent with bladder
exstrophy or siblings of a child with bladder exstrophy
have an increased chance of being born with the
condition.

Race:- Bladder exstrophy is more common in whites then in

other races

Sex:- More boys than girls are born with bladder exstrophy

Use of assisted reproduction:-

Children born through assisted the productive technology, such
as IVF have a higher chances of having it
TREATMENT
The treatment of bladder exstrophy typically involves a series of surgical procedure
and ongoing management. The primary goal of treatment is to re-construct the
bladder and abdominal wall, establish urinary incontinence and address associated
abnormalities. Here are the key aspects of treatment for bladder exstrophy.

q initial surgical repair: this procedure is usually performed soon after birth
,within the first few days or weeks . This surgery aims to close the
abdominal wall and bring the exposed bladder back inside the body . It
involves reconstructing the pelvic bones, repairing the bladder , and
creating a functional urinary tract. The specific surgical techniques may
vary depending on the individual’s condition and surgeon’s approach.

q Bladder reconstruction: subsequent surgeries focus on reconstructing the

bladder to improve its capacity and functionality. This may involve
procedures such as bladder neck reconstruction, bladder augmentation and
ureteral reimplantation to ensure proper urine flow
● Genital reconstruction- in some cases, additional surgeries may be
required to address any abnormalities in the genitalia, such as
epispadias ( malformations of the urethra) or other associated
conditions. These surgeries aim to achieve a more normal appearance
and function.

● Urinary continence management- achieving urinary continence or the

ability to control urination is an important aspect of treatment for
bladder exstrophy.

● Bladder training- the individual with the guidance of the Healthcare

professionals learn techniques and exercise to improve bladder control
such as timed voiding and relaxation technique

● Medication- medications may be prescribed to manage urinary

incontinence or other related issues
References
mayoclinic.org
Clevelandclinic.org
Google.co.in