Bladder exstrophy is a rare congenital abnormality where the bladder lies exposed to the outside world due to incomplete formation of the lower abdominal wall during foetal development. This condition can lead to difficulties in storing and voiding urine resulting in urine leakage (incontinence) and potential kidney damage if left untreated. Bladder exstrophy may be diagnosed before birth through pre-natal ultrasounds, but most commonly diagnosis occurs once the baby is born. Diagnosis will include ultrasound scans and x-rays of the urinary system to check for the extent of the disorder.
At the specialist centre, patients will be provided with a comprehensive service offering multidisciplinary care from a team of experts including paediatric urologists, nurses, physiotherapists and psychologists.
Admission to the specialist centre will occur soon after birth. As well as the usual post-natal care, babies with bladder exstrophy will have a clear cover placed over their abdomen to protect the bladder from infections. Within their first few days of life, they may undergo an operation to close the opening in their abdominal wall so that the bladder is no longer exposed. They will also have catheter inserted to drain urine from their bladder. Management for bladder exstrophy may involve a series of operations over the first few years of their life as well as appointments to monitor the kidneys for any abnormalities.
In addition to surgical management, the bladder exstrophy service includes long-term follow up care to monitor the child’s urinary system and assess for any complications. Physiotherapy is provided to help the child with their bladder and pelvic floor function. They will also receive psychological support as they enter various stages of life such as school, to help them adjust and thrive despite their condition.
Credits:
Ines Djedje – University of Mancheser 5th year medical student
Sources:
- Gearhart, J P et al. “Criteria for the prenatal diagnosis of classic bladder exstrophy.” Obstetrics and gynecology vol. 85,6 (1995): 961-4. doi:10.1016/0029-7844(95)00069-4
- Bladder exstrophy and epispadias | Great Ormond Street Hospital (gosh.nhs.uk)