The physicians and staff of the Pediatric Urology Group evaluate and treat your child’s pediatric urological condition with the expertise of a skilled professional and the compassion of a caring parent.
Posterior Urethral Valves (PUV) Repair
Pyeloplasty, daVinci Robotic Assisted
Undescended Testis (Orchiopexy)
Urinary Tract Infection (UTI) Treatment
Vesicoureteral Reflux (VUR) Treatment
The hollow organ in the lower abdomen that stores urine.
An abnormality that occurs in males when the urethra is on the upper surface of the penis.
Malformation of an organ.
The canal through which urine is discharged from the bladder.
Bladder exstrophy is a rare occurrence in which the bladder and associated structures are improperly formed. Instead of being the normal round shape, the bladder is flattened, and the skin covering the lower part of the abdomen does not form properly so the inside of the bladder is exposed outside the abdomen.
Generally, classic bladder exstrophy is an isolated birth defect; however, spinal cord abnormalities occur in about 13% of cases. If this condition is detected before birth, a pediatrician and surgeon will assess the baby immediately. If the condition is not detected until the time of birth, transfer to a facility where he or she can be assessed will be immediately arranged. In either case, the bladder will be visible outside of the baby’s abdomen.
The surgeries necessary to correct this condition are threefold. The first is closure of the exstrophied bladder and proper placement of the public bone. During this surgery, the separated pelvic bones are brought together, the bladder is closed and placed inside the pelvis, and the abdominal wall is closed over the repaired bladder. This is best completed within the first 72 hours of life. After the bladder is closed, the infant will be placed in traction where the position of the hips have 90 degrees of flexation, the knees and ankles are held together, and the buttocks are slightly elevated. This traction may be necessary for three to four weeks.
The second surgery is involves genital repair, and is performed at different times for boys and girls with exstrophy. In females, the genitalia and urethral repair can often be done at the time of the initial bladder closure. In males, a procedure called epispadias repair is done between one and two years of age. During this surgery, the penis and urethra are reconstructed, and bladder growth and capacity is stimulated.
The third stage of this corrective procedure is performed to achieve urinary continence, around the age of 4-5 years. During this surgery, the ureters are repositioned to prevent reflux of urine back up to the kidneys and a bladder sphincter is created that can open and close.
Given the development of a bladder with sufficient capacity, continence can be achieved in up to 90% of cases, depending on the quality of the bladder template and the success of the initial bladder closure.
The recovery period is dependent on the severity of the bladder defect, other medical issues, and the number of surgeries required to correct the condition.