Health Encyclopedia

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
Reviewed 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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