Bladder exstrophy

Exstrophy of bladder

Exstrophy of bladder is birth defect in which bladder develops outside fetus.

Exposed bladder can't store urine or function normally. 

Anterior surface of bladder on abdominal wall instead of being enclosed within abdomen.

Clinical features in male

1. Anterior abdominal wall is absent and posterior bladder lining bright red in colour exposed. 

Urine seeps into posterior bladder wall from abnormal urethral outlets.

2. Epispadias (urethra not develop into full tube) with dorsal chordae. Penis appear to short, penis curve outward.

3. Undescended testes

4. Inguinal hernia (Groin hernia)

5. Abnormal distance between penis and scrotum.

6. Separated pelvic bone.

In female

1. Bifid clitoris

2. Vaginal opening appears narrow

Management

1. Urinary diversion

2. Uretero sigmoidostomy

3. Illeal conduit

4. Colonic conduit  anti reflux procedure

6. Primary reconstruction of bladder