Exstrophy of the bladder is a very complicated urinary tract abnormality that involves the lower abdominal wall, the pelvis and the genitalia. At the time of birth, the bladder is open and forms the lower part of the abdominal wall. Both male and female genitalia are formed abnormally. The pubic bone is separated and the pelvis is therefore open. This is a diagnosis that can be made prenatally, but often comes as a surprise on the day of birth.
Management of bladder exstrophy is complicated, and cannot be adequately summarized on a web page. The bladder must be closed, and the pelvis and abdominal wall brought together in the front. The genital abnormalities must be corrected, either at the same time as infant closure, or at a subsequent procedure. In the male, this is called epispadias repair. Most children with bladder exstrophy also have vesicoureteral reflux and most will require a secondary procedure in order to achieve urinary continence.
Our faculty follow patients with bladder exstrophy from all over the United States and the world. Although much emphasis has been placed on the newborn repair of exstrophy, older children, adolescents and even adults with this condition require treatment and surgery. Reconstruction of the older child and adult with bladder exstrophy is a particular interest at the Children’s Hospital of Pittsburgh, and pioneering work such as laparoscopic-assisted bladder reconstruction has been developed by our faculty. If you child has bladder exstrophy and you desire further information, please do not hesitate to contact us.
