Surgery to correct exotrophy of the urinary bladder

A malformation of the genitourinary system’s organs, in which the anterior abdominal wall and the anterior wall of the bladder are absent, there is a splitting of the urethra and the divergence of the pelvic bones up to 7 centimeters – this is exstrophy of the bladder.

EMF is detected in one in 40,000-50,000 newborns and is approximately 2-3 times more common in boys.

A protrusion of the mucous membrane of the posterior wall of the bladder in the suprapubic region, which has a bright red color, is determined in a child. With exstrophy of the bladder in boys, urine constantly excreted from the orifices of the ureters. The skin in this area gradually scarred; their maceration occurs due to constant contact with urine. The navel is most often absent. The penis reduced in size, most often split.

In girls, the urethra also split. The clitoris divided into two parts. The labia can represent in two halves. The vagina covered by the mucous membrane of the bladder and urethra. Besides, there is a divergence of the pelvic bones in the pubic articulation up to 7 centimeters, which leads to a violation of gait. Constant contact of the bladder’s mucous membranes with the surrounding tissues and the external environment leads to the development of cystitis and pyelonephritis with subsequent wrinkling of the kidneys.

Children practically deprived of the opportunity to communicate and usually play with their peers; they always smell urine.

Diagnostics

The diagnosis of EMF is most often made immediately after the birth of the child. However, it is possible to suspect the bladder’s exstrophy in utero with an ultrasound examination of the fetus. At various stages of pregnancy, your doctor should see a full bladder. The absence of a shadow of the bladder during a series of examinations should be a reason to suspect EMF diagnosis.

Treatment at Tel Aviv Medical Clinic

Bladder exstrophy is only subject to surgical treatment. Correction of the defect should be performed early in the child’s life. All types of operations are performed from birth to 1-2 years old when scar tissue around the bladder has not yet occurred. The volume of surgical interventions depends on the size of the exstrophy, the child’s general condition, and his gender. Surgical treatment of this defect consists of several stages:

1. plasty of the anterior abdominal and anterior wall of the bladder;
2. correction of urethral splitting and penile plastic surgery;
3. elimination of urinary incontinence with possible augmentation of the bladder.

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