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Exstrophy of the Bladder and Epispadias in ChildrenWhat is exstrophy of the bladder and epispadias in children?Exstrophy of the bladder is when a baby’s bladder has grown inside out and is sticking through the wall of the belly (abdomen). The bladder can be seen in the front of the child’s lower belly. It is a rare condition. It includes problems with how the urinary tract, muscles, bones, and the digestive system grew in the womb. Epispadias is a problem often seen with exstrophy of the bladder. It is when the opening of the tube that carries urine out of the body (the urethra) is in the wrong place. In a baby boy, the opening is often on the top of the penis. But with this condition, the opening may be the whole length of the penis. In a girl, the opening may also be longer, and higher in the urethra. It may open right next to the bladder. What causes exstrophy of the bladder and epispadias in a child?Experts don't know what causes these problems. What are the symptoms of exstrophy of the bladder and epispadias in a child?The disorder varies from mild to severe. A child with exstrophy of the bladder may have a triangle-shaped opening in the belly where the bladder can be seen. The bladder will look bright pink. A boy may also have a short, small penis with a urethral opening along the top of the penis (epispadias). A girl may also have a narrow vaginal opening, a wide labia, and a short urethra. In many cases, a child with exstrophy of the bladder may also have these problems:
How is exstrophy of the bladder and epispadias diagnosed in a child?Exstrophy of the bladder can be diagnosed by fetal ultrasound before a baby is born. After the baby is born, the healthcare provider will give your child a physical exam. Your child may also have imaging tests. These are done to look at the positions of organs and other tissues. How is exstrophy of the bladder and epispadias treated in a child?Treatment is done with surgery. There are often 3 stages of surgery to fix the problems. They are:
Talk with your child’s healthcare providers about the risks, benefits, and possible side effects of all treatments. What are possible complications of exstrophy of the bladder and epispadias in a child?Even with surgery, a child may not be able to control his or her urine (urinary incontinence). Newer surgery methods make it possible for most children to control their urine over time. But a child may have long-term damage to the urinary tract and kidneys. In some cases, the problem may also cause loss of fertility in the future. This means that when the child is an adult, it may be hard to have children. When should I call my child’s healthcare provider?Call the healthcare provider if your child has:
Key points about exstrophy of the bladder and epispadias in children
Next stepsTips to help you get the most from a visit to your child’s healthcare provider:
What are the clinical features of bladder exstrophy?The main symptom of bladder exstrophy is the bladder protruding through an opening in the belly. Bladder exstrophy can lead to other symptoms, including: Smaller-capacity bladder. Lower-than-usual belly button.
What abnormalities are associated with bladder exstrophy?In classic bladder exstrophy, most anomalies are related to defects of the abdominal wall, bladder, genitalia, pelvic bones, rectum and anus. Bladder exstrophy is a rare developmental abnormality that is present at birth (congenital) in which the bladder and related structures are turned inside out.
Which finding is associated with a male infant born with exstrophy of the bladder?When a boy is born with bladder exstrophy, the bladder and urethra are open and seen as a divided structure (halves) on the outside of the body, the penis may be flat and short, and the top of the penis may open to the bladder.
How is bladder exstrophy diagnosed?Bladder exstrophy is found incidentally during a routine pregnancy ultrasound. It can be more definitively diagnosed before birth with ultrasound or MRI. Signs of bladder exstrophy seen during imaging tests include: Bladder that doesn't fill or empty correctly.
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