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About The Treatment

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Bladder Exstrophy and Epispadias Treatment

Exstrophy means "inside out". Bladder exstrophy is a congenital innate anomaly of the bladder. This means that this condition is visible when the child takes birth. It happens when the skin over the bottom part of the abdomen does not shape appropriately, so the bladder remains open and uncovered.

An epispadias is an uncommon distortion of the penis. In this condition, the urethra closes in the opening on the upper part of the penis. It can likewise also happen in females, when the urethra grows too far anteriorly.

In young boys with epispadias, the penis tends to be broad, short and bent up (dorsal chordee). The pelvic bones are broad and isolated. In epispadias, the penis is appended to widened pelvic bones, which leads to the penis being pulled back toward the body.

Why the Surgery is Sought?

  • Adequate bladder function must be developed
  • Urinary continence must be paid attention to.
  • The sooner the condition is treated, the better. It is essential to operate immediately once the diagnosis has been made.
  • The surgery is done to improve the appearance and function of the external genitalia so that the child leads a healthy life.
  • Kidneys are essential organs of our body which are responsible for draining waste in the liquid form. Surgery must be sought to avoid a life-threatening situation.

What are the Possible Treatments for Exstrophy and Epispadias?

  • CPRE is an invasive procedure in which the bladder is shut and the epispadias is repaired. In short, the whole urethra is closed into a tube. Children who experience CPRE will probably require extra care and follow ups that will stretch for some years. The doctors will look out for urinary incontinence and vesicoureteral reflux (VUR). This strategy is generally performed when the child reaches at 6 months of age.
  • MSRE consists of three steps to reconstruction of the bladder:

Stage 1: The bladder and stomach divider are shut, the tummy catch is remade, and an osteotomy is at times played out (the pelvic bones are improved to help in the repair). The underlying repair is customarily performed in the children who are 2-3 years old.

Stage 2: In boys, the proximal portion of the urethra near the bladder is shut alongside the bladder. In girls, the urethra is generally closed along its whole length. The second stage repair happens when the child is at least 6 months of age.

Stage 3: This stage includes bladder neck recreation with two-sided ureteral reimplantation. The procedure is performed when the bladder has developed adequately to hold a suitable volume of urine. This intervention is done in the children who are at least 6 years of age.

What is the Outcome?

  • Surgical treatment can lessen difficulties of the patient.
  • The corrective surgery will increase the self-confidence and a sense of positive body image in young girls and boys.
  • Children who underwent surgery will be able to hold their urine.
  • Girls with bladder exstrophy may lead a healthy sexual life. They can give birth naturally, despite the fact that complications will be present.

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Hospitals

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Indraprastha Apollo

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