Bladder and Cloacal Exstrophy

Mitchell, Michael E.; Grady, Richard W.

doi:10.1016/b978-1-4160-6127-4.00059-8

Cited by 1 publication

(2 citation statements)

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“…The commonest ultrasound fi ndings are identifi ed before the 20th week of gestation and include absence of bladder fi lling, low set umbilicus, pubic bone diastasis, diminutive genitalia and lower abdominal mass that increases in size as the pregnancy progresses. [4][5][6] In our patient, the only fi nding at the prenatal checkup was the diffi culty in determining the gender.…”

Section: Discussionmentioning

confidence: 99%

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Long Term Follow Up of Complete Bladder Exstrophy Repair. A Case Report

Mouskou¹,

Dionysis²,

Aivazoglou³

et al. 2014

Folia Medica

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OBJECTIVE:Bladder exstrophy is a congenital anomaly which is not always successfully managed by surgery. Major goals of surgical intervention in such cases are preservation of normal renal function, development of adequate bladder function and urinary continence and avoidance of future urinary tract infections. We present 5-year data on a patient who underwent complete repair of the bladder exstrophy. CASE REPORT : We describe a full term female infant who presented at birth with complete bladder exstrophy. Complete repair of the condition was performed 3 days after birth (Ransley technique). During hospitalization the patient had a positive urinary culture with Candida lusitaniae, enterococcus and septicemia with Klebsiella pneumoniae ESBL. The patient had no complications until the age of 20 months when she developed an episode of pyelonephritis and fi ve further episodes of cystitis with E. coli. Radiographic testing showed small bladder capacity (23 ml at the age of 3 years), bilateral vesicoureteral refl ux, a long stenotic urethra and no loss of renal function. Because of the recurrent urinary tract infections, dilatations of the stenotic urethra (Scheldinger technique) were successfully performed at the age of 3. Twenty-two months later the child had negative urinary cultures, a normal renal function and had also gained partial control of the bladder sphincters. CONCLUSIONS: Surgical repair of bladder exstrophy remains a challenging surgery for the pediatric urologist. Following surgical correction both early and long-term post-operative complications may be present. Longitudinal follow up is required by an experienced team of health care professionals.Key words : bladder exstrophy, neonate, complications Folia Medica 2014; 56(1): 60-63 Copyright © 2014 Medical University, Plovdiv РЕЗЮМЕ ЦЕЛЬ: Экстрофия мочевого пузыря представляет собой врожденную аномалию, которую не всегда возможно успешно лечить оперативным методом. В таких случаях основной целъю хирургической интервенции являются сохранение нормальной почечной функции, достижение адекватного функционирования мочевого пузыря и нормальной континенции, а также и избежание будущих инфекций мочевых путей. В работе авторы представляют пятилетнее прослеживание пациента, перенесшего полное восстановление экстракорпорального мочевого пузыря. КЛИНИЧЕСКИЙ СЛУЧАЙ: Авторы сообщают о мальчике, родившемся в сроке с полной экстрофией мочевого пузыря. Проведена полная реконструкция пузыря на третий день после рождения по методу Ransley. Лабораторные тесты пациента во время госпитализации показали положительную культуру мочи -Candida lusitaniae с энтерококками и септицемию с Klebsiella pneumoniaе ESBL. Пациент без осложнений до 20-имесячного возраста, когда развивает пиелонефрит и 5 раз заболевает циститом, вызванным E. coli. Рентгенологическое исследование показывает мочевой пузырь небольшого объема (23 мл, в возрасте 3 лет), двусторонний везикоуретеральный рефлюкс, стеноз уретры и сохраненную почечную функцию. В возрасте 3 лет проведена дилатация уретры (...

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Section: Discussionmentioning

confidence: 99%

“…[2][3] It is a complex congenital abnormality which affects the musculoskeletal, urogenital and gastrointestinal systems. 4 The abnormality can be diagnosed prenatally.…”

Section: Introductionmentioning

confidence: 99%