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Definition of Bladder Exstrophy
Bladder Exstrophy – an uncommon congenital anomalY in which the structures of the lower pelvis fail to form properly. As a consequence, the bladder protrudes outside the body and may be open or inverted.
The urethra often fails to close as well. Bladder exstrophy is a random birth defect and is not a hereditary birth defect.
About 100 infants are born with bladder exstrophy, which varies widely in severity, each year in the United States.
Treatment, Repair and Surgery
Treatment in most cases is surgery within several days of birth to reconstruct and reposition the bladder, urethra, symphysis pubis, and other pelvic structures. Most children born with bladder exstrophy require follow-up operations through early childhood and perhaps at puberty when secondary sex characteristics alter the appearance and function of the genitalia. However, even with surgical repair or reconstruction the urethral sphincter muscle at the neck of the bladder may not function properly, resulting in incomplete control over the flow of urine.
This urinary incontinence may remain throughout life, though there are medical therapies and lifestyle methods to manage the condition. vesicoureteral reflux, in which urine flows (refluxes) from the bladder back up the ureters, is also common.
Appropriate reconstructive surgery maintains fertility. Men may experience retrograde ejaculation, in which sperm travel inward through the urethra and into the bladder during ejaculation rather than outward through the urethra to exit the penis. In such a circumstance a fertility expert can retrieve the sperm and place them into the woman to achieve fertilization.
Women born with bladder exstrophy generally are able to carry pregnancy to term and deliver vaginally as long as the circumstances of the pregnancy permit.
See also BIRTH DEFECTS; EPISPADIAS.
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