Extrophy Of The Bladder
Bladder exstrophy (also known as Ectopia vesicae) is a congenital anomaly that exists along the spectrum of the exstrophy-epispadias complex and most notably involves protrusion of the urinary bladder through a defect in the abdominal wall.
What Does Extrophy Mean
Bladder exstrophy is a congenital abnormality that occurs when the skin over the lower abdominal wall (bottom part of the tummy) does not form properly. The bladder is open and exposed on the outside of the abdomen. In epispadias, the urethra does not form properly. Exstrophy means 'turned inside out'.
Congenital heart DEFECT
We identified 205 patients with exstrophy among 9,452,110 newborns. The overall weighted incidence of exstrophy was 2.15 per 100,000 live births. The male-to-female ratio was almost even (OR 0.989, 95% CI 0.88 to 1.12). White infants were significantly more likely to present with exstrophy than nonwhites (incidence 2.63 vs 1.54 per 100,000, p <0.0001). Exstrophy incidence also varied by geographic region, socioeconomic status (SES) and insurance status. On multivariate analysis the racial variation in exstrophy incidence persisted even after adjustment for geographic region, SES and insurance status. Conditions such as spina bifida, cleft palate, preterm birth and gastrointestinal anomalies were more common in newborns with exstrophy.
Bladder exstrophy is rare, occurs in equal numbers of live male and female newborns, and is associated with certain co-morbid conditions. Incidence appears to be stable through time. Nonwhite race, uninsured status, high or low SES and Western geographic region are associated with lower exstrophy incidence.
Causes and symptoms
The cause of bladder exstrophy is not known. Some studies show a clustering of the condition in families, suggesting that there’s an inherited factor. However, the chance for parents to have another child with exstrophy of the bladder is less than 1 percent.
How is it diagnosed?
Because the bladder and other structures are exposed on the outer surface of the body, bladder exstrophy can be diagnosed immediately at birth. In some cases, however, the condition is discovered before the baby is born through images produced by a fetal ultrasound or other imaging techniques such as magnetic resonance imaging (MRI).
How is it treated?
Ultrasound before birth. A prenatal ultrasound is a test that uses sound waves to create pictures of the developing fetus. ... As the fetus continues developing, it may be easier to accurately diagnose a cleft lip. Cleft palate that occurs alone is more difficult to see using ultrasound
Treatment for exstrophy of the bladder begins at birth. The most important goals in the care of a boy or girl with bladder exstrophy are to:
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Contemporary epidemiology of bladder exstrophy in the United States.Nelson CP1, Dunn RL, Wei JT.
Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.
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