CONGENITAL EXTROPHY OF BLADDER
DR ANIL S. NELIVIGI
DR. MANJUNATH (Pediatric surgeon)
DR. SUNILKUMAR P.D
DR. SACHIN S. NIMBARGI
DR. LOKESH NAIK G.
Properly the extrophy
epispadias complex is a rare congenital anomaly occurring one in every
40000-50000 live births with 2:1 male :female ratio. The diagnosis
involves the spectrum of anomalies of the lower abdominal wall, bladder,
anterior bony pelvis and external genitalia. It occurs due to failure of
the abdominal wall to close during fetal development and results in
protrusion of the posterior bladder wall through the lower abdominal
wall. Treatment is with surgical correction of the defect but patients
can still have long term issues with urinary tract infections and sexual
dysfunction.
We operated on a case of
congenital extrophy of bladder with urologic and orthopedic
reconstruction procedures. The male child was 3yrs old with neglected
total extrophy of bladder and pubic diastasis. The operating team
consisted of orthopedic and pediatric surgeons. First the bilateral
iliac osteotomy was done and anterior diastasis was closed and fixed
with stainless steel wire augmented with external fixator frame through
both iliac wings. This was followed by the reconstruction of urethra,
bladder and closure of anterior abdominal wall and urine was rerouted
externally through drain tubes. Patient still requires multiple
surgeries for reconstruction of ureters and external genitalia in near
future.
