Bladder Exstrophy

What is Bladder Exstrophy?

Bladder Exstrophy is a congenital defect where the bladder develops outside the fetus. The skin over the lower abdominal wall is not formed properly due to which the bladder is open and exposed.

Based on severity, bladder exstrophy may involve abnormalities in the bladder, genitals,  pelvic bones, intestines and reproductive organs too.

What causes Bladder Exstrophy?

The exact causes of bladder exstrophy are not known. The risk factors include:

Genetic Makeup

The gene ISL1, which is important in regulating urinary tract development is believed to cause the condition.

Environmental Factors

Age of mother, use of progesterone during pregnancy, assisted reproduction, and smoking during pregnancy could cause the condition.

What are the symptoms of Bladder Exstrophy?

Bladder Exstrophy is associated with other conditions. So, the doctor closely examines the scan reports to observe the development of the baby’s organs throughout pregnancy. Post delivery, he thoroughly examines and conducts tests  to identify the associated conditions.  Some of them are:

Epispadias

Urethra is not fully developed

Cloacal exstrophy

The rectum, bladder and genitals did not separate during fetus development

Omphalocele

Abdominal organs are protruding

How is Bladder Exstrophy diagnosed?

Bladder exstrophy is usually diagnosed before birth through ultrasound and MRI reports. Doctors examine the reports to check if:

• The umbilical cord is low on the abdomen
• Pubic bones are separated
• Bladder does not fill or empty properly
• The genitals are smaller than normal

After the birth, the areas of focus are:

• Position of the testicles
• Extent to which the bladder is exposed
• Anatomy around navel
• Position of rectum

What are the treatments for Bladder Exstrophy?

Bladder exstrophy is corrected with reconstructive surgeries. The goals of the procedures are:

• To create organs that look and function acceptably
• Provide space for urine storage
• Facilitate bladder control
• Protect kidney function

The two basic approaches of surgery are:

• Complete primary repair of bladder exstrophy (CPRE)
• Modern staged repair of bladder exstrophy (MSRBE)