Exstrophy of the bladder-epispadias
Overview
Exstrophy of the bladder is a complex combination of disorders that occurs during fetal development. The disorder usually involves many systems in the body, including the urinary tract, skeletal muscles and bones, and the digestive system. Bladder exstrophy means that the bladder is essentially inside out and exposed on the outside of the abdomen. Because the bladder and other structures are exposed to the outside of the body, urine constantly trickles onto the skin causing local irritation.
Causes
* No risk factors or causative agents are known. * Offspring of patients with exstrophy-epispadias complex have a 1 in 70 risk (500 times that of the general population) of being affected. * Exstrophy has been reported in twins. In no cases were fraternal twins both affected. While all sets of identical twin males were concordant for exstrophy, in none of the sets of female identical twins were both twins affected. * A higher incidence of bladder exstrophy is observed in infants of younger mothers and in those with relatively high parity. * Heredity of cloacal exstrophy has not been established, since no offspring have been reported.
Diagnosis
Exstrophy of the bladder can usually be diagnosed by fetal ultrasound before an infant is born. After the infant is born, exstrophy can be determined by physical examination. Your child's physician may order other diagnostic procedures.
Treatment
Specific treatment for exstrophy of the bladder and epispadias will be determined by your child's physician based on: * Your child's age, overall health, and medical history. * The extent of the disorder. * Your child's tolerance for specific medications, procedures, or therapies. * Expectations for the course of the disorder. * Your opinion or preference.