Exstrophy of the bladder is a severe congenital pathology of the urinary system, in which the organ is placed not inside the stomach, but outside. It occurs in one of 50,000 newborns. In boys, this pathology is diagnosed four times more often than in girls. To eliminate it, surgical intervention is used effectively.
Bladder exstrophy - causes
Many factors contribute to the appearance of such pathology. More often the malformations of the bladder are caused by the following reasons:
- Genetic predisposition - if one of the relatives had such a disease, there is a great chance that this pathology will occur in the child.
- Infectious diseases , which the woman suffered during pregnancy - they provoke serious complications, including the developmental defects of the genitourinary system.
- Diabetes maternal diabetes - this disease can cause incorrect formation of internal organs.
- An environmental factor - a pregnant woman is important to walk more in the fresh air, to avoid smoky rooms and contact with aggressive chemicals. An unfavorable environment can provoke the development of a child's blemish.
- Harmful habits of a pregnant woman - smoking , taking drugs and drinking alcohol abuse contribute to the appearance of pathologies in the fetus.
Exstrophy of the bladder - symptoms
This pathology is accompanied by a pronounced clinical picture. Exstrophy of the urinary bladder in children can be visually detected immediately after birth by such signs:
- In the lower abdomen, an obvious defect in the abdominal cavity is seen - the bladder is on the surface.
- Urine is constantly excreted, due to which on the skin in the area of intimate places there are diaper rash.
- In most cases, there is no umbilical scar.
- The urinary system is located too close to the anus.
- The child because of the experienced discomfort becomes nervous, capricious and badly eats, which affects his weight gain.
Exstrophy of the bladder and epispadias
Both pathologies are congenital. Exstrophy of the bladder is the absence of the anterior abdominal wall and the prolapse of the excretory system to the outside. There are such stages of pathology:
- The first degree is the divergence of the pubic bones no more than 4 cm. The diameter of the lesion on the abdominal cavity is less than 4 cm.
- The second degree - the bones diverge to a distance of 4.5-8 cm. The diameter of the hole on the peritoneum varies from 5 to 7 cm.
- The third degree is the divergence of the pubic bones more than 9 cm. In diameter, the abnormal lesion exceeds 8 cm.
Epispadia of the urinary bladder is the underdevelopment of the external genitalia. In boys this pathology can be:
In girls epispadia occurs in such forms:
This pathology is also known as an ectopic cloaca or a vesicouca cleft. It is a severe form of anomaly. The upper part of the formation is the umbilical hernia, the lower one is the bladder. The organ of the excretory system is split into two parts by the isthmus of the intestine. Each "half-bubble" has its own opening of the ureter. The same fragment of the intestine that comes out, has from 2 to 4 lumens.
Cloacal exstrophy of the bladder is accompanied in boys by such anomalies:
- splitting of the penis;
- undescension of testicles;
- widely "spread out" by the bony bones.
At girls exstrophy proceeds simultaneously with such anomalies:
- doubling the vagina;
- cleavage of the clitoris;
- the bicornic uterus .
Exstrophy of the bladder - treatment
The only way to get rid of this pathology is to perform an operation. Before such a procedure, a comprehensive examination of the patient, including:
- endoscopic examination;
Only after a diagnostic study of bladder exstrophy, total epispadia is eliminated surgically. The main tasks pursued by the doctor in this treatment are:
- Carry out a safe closure of the urinary system, which "went out".
- Perform a plastic reconstruction of the affected area.
Exstrophy of the bladder - operation
How surgical intervention will be performed largely depends on the size of the defect. When the diameter of the pathological hole on the abdominal cavity does not exceed 4 cm, close tissue is used to close it. If there is a larger size of exstrophy, the treatment involves the use of an artificial "skin" - a sterile film. After the suture heals, repeated surgical intervention is performed. During this procedure, the film is removed.
After surgery, when cloacal or bladder exstrophy is eliminated, there is a risk of developing such complications:
- enuresis ;
- adhesive disease;
- contamination of blood.
Bladder exstrophy clinical - recommendations
In the post-operation period, the doctor who performed the surgery will prescribe combined antibacterial therapy. Reception of medicines is carried out in a hospital under the supervision of a doctor. More often antibacterial preparations are administered to patients intramuscularly or intravenously.
After completion of such therapy, the doctor will give the patient his recommendations, which in most cases are reduced to the following rules:
- Bladder exstrophy in girls or boys is a pathology in which you have to completely change your lifestyle. This applies to nutrition. In the diet should be healthy food. Acute and salty foods, as well as diuretics will have to be excluded from the menu.
- You can not consume a lot of fluids. Drink in small sips.
- All subsequent life should avoid injuries and strong physical exertion, including intense sports.
- Regularly you need to visit a doctor.