Bladder exstrophy

Amanda C. North, John P. Gearhart

Research output: Chapter in Book/Report/Conference proceedingChapter

1 Citation (Scopus)

Abstract

Bladder exstrophy is part of a spectrum of genito-urinary tract anomalies ranging from epispadias to cloacal exstrophy. It involves defects in the abdominal wall, bladder, genitalia, pelvic bones, rectum, and anus. There is a triangular fascial defect which is occupied by the exstrophied bladder and posterior urethra. This defect extends from the umbilicus, which is situated below the horizontal line of the iliac crest, to the intrasymphyseal band. Indirect inguinal hernias are frequently present. It is characterized by the absence of a portion of the lower abdominal wall and the anterior vesical wall, with eversion of the posterior vesical wall through the deficit. The bladder mucosa may be normal at birth or there may be hamartomatous polyps, or more rarely ectopic bowel mucosa, or an isolated bowel loop on the surface. The ureters follow an abnormal course due to the enlarged and deep pouch of Douglas. This forces the ureters to be inferiorly and laterally displaced. With bladder closure vesico-ureteral refl ux occurs in 100% of cases. Patients with classic bladder exstrophy have widening of the pubic symphysis, external rotation of the posterior aspect of the pelvis, retroversion of the acetabulum, external rotation of the anterior pelvis, and a 30% shortening of the pubic bones. The incidence of bladder exstrophy is estimated to be between 1 in 10,000 and 1 in 50,000 live births. There is a male preponderance with a male to female ratio of 5:1 to 6:1.

Original languageEnglish (US)
Title of host publicationPediatric Surgery: Diagnosis and Management
PublisherSpringer Berlin Heidelberg
Pages629-634
Number of pages6
ISBN (Print)9783540695592
DOIs
StatePublished - 2009
Externally publishedYes

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Bladder Exstrophy
Urinary Bladder
Abdominal Wall
Ureter
Pelvis
Mucous Membrane
Epispadias
Pubic Bone
Douglas' Pouch
Pubic Symphysis
Pelvic Bones
Umbilicus
Acetabulum
Genitalia
Inguinal Hernia
Anal Canal
Live Birth
Urethra
Polyps
Urinary Tract

ASJC Scopus subject areas

  • Medicine(all)

Cite this

North, A. C., & Gearhart, J. P. (2009). Bladder exstrophy. In Pediatric Surgery: Diagnosis and Management (pp. 629-634). Springer Berlin Heidelberg. https://doi.org/10.1007/978-3-540-69560-8_64

Bladder exstrophy. / North, Amanda C.; Gearhart, John P.

Pediatric Surgery: Diagnosis and Management. Springer Berlin Heidelberg, 2009. p. 629-634.

Research output: Chapter in Book/Report/Conference proceedingChapter

North, AC & Gearhart, JP 2009, Bladder exstrophy. in Pediatric Surgery: Diagnosis and Management. Springer Berlin Heidelberg, pp. 629-634. https://doi.org/10.1007/978-3-540-69560-8_64
North AC, Gearhart JP. Bladder exstrophy. In Pediatric Surgery: Diagnosis and Management. Springer Berlin Heidelberg. 2009. p. 629-634 https://doi.org/10.1007/978-3-540-69560-8_64
North, Amanda C. ; Gearhart, John P. / Bladder exstrophy. Pediatric Surgery: Diagnosis and Management. Springer Berlin Heidelberg, 2009. pp. 629-634
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