Presentation
History of abnormal gait, continuous dribbling of urine, deficient lower abdominal muscles and ambiguous genitalia.
Patient Data
Serial IVP films showing:
Widely separated pubic bones with absent symphysis pubis.
There is no identifiable shape of urinary bladder due to lack of anterior bladder wall.
Ureters are laterally and upward angulated at the ureterovesical junctions.
Extravasation of contrast is seen extending from urinary bladder to the exterior.
Case Discussion
Bladder exstrophy or "ectopia vesicae" is characterized by a deficient lower anterior abdominal wall along with the anterior walls of urinary bladder. There may be a rudimentary posterior wall of the urinary bladder.
Associated bony findings include widely separated pubic bones with absent symphysis pubis, leading to characteristic "waddling gait".
Surgical repair is treatment of choice to close defect and to improve patients quality of life by preventing dribbling of urine, repeated urinary tract infections leading to renal failure and in long-standing cases to prevent malignant transformation due to repeated irritation.
Unable to process the form. Check for errors and try again.