Bladder-neck repair in urinary bladder exstrophy

1999 ◽  
Vol 15 (3-4) ◽  
pp. 290-293 ◽  
Author(s):  
V. Bhatnagar ◽  
R. Lal ◽  
S. Agarwala ◽  
D. K. Mitra
2020 ◽  
Vol 7 (5) ◽  
pp. 1155
Author(s):  
Tazeem Fatima Ansari ◽  
Prachi Gandhi ◽  
Poonam Wade ◽  
Vinaya Lichade Singh ◽  
Kiran Khedkar ◽  
...  

Exstrophy of urinary bladder with epispadias involves protrusion of the urinary bladder through a defect in the lower abdominal wall accompanied by separation of pubic symphysis. It is a rare but challenging condition that causes significant physical, functional, social, sexual and psychological problems later in life. Bladder exstrophy commonly involves males and most cases are sporadic.  Inguinal hernia is a complication associated with bladder exstrophy and it occurs due to lack of obliquity of the inguinal canal secondary to pubic diastasis.  Authors report here, a case of antenatally diagnosed case of classic bladder exstrophy associated with left sided inguinal hernia which was incidentally diagnosed on tenth day of life. Our neonate underwent primary bladder closure with herniotomy. Staged reconstruction of epispadias and bladder neck has been planned at a later date. Recurrence of inguinal hernia after repair is common and bilateral inguinal exploration while performing herniotomy is advised to prevent its recurrence. Prognosis of such cases depends on the degree of continence achieved. With timely reconstructive surgery, continence rates can be as high as 60-70 percent.


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Bharati K. Kulkarni ◽  
Nandita Saxena ◽  
Shyam S. Borwankar ◽  
Hemant N. Lahoti ◽  
Pooja Multani ◽  
...  

Abstract Background Urinary incontinence is a major problem in operated exstrophy patients. Most of the repairs described in literature stress on the importance of dividing the intersymphyseal band (ISB) to place the bladder in the pelvis. But the origin of this band and its importance has hardly been discussed in literature. The purpose of this study is to establish the nature of tissue the ISB is composed of. This can be used to determine its role in the surgical management of exstrophy epispadias complex (EEC) patients. Results Thirty out of 33 operated patients demonstrated smooth muscle with/without fibrous tissue in the sections taken through the ISB. A significant percentage of patients (χ2= 38.319, p < 0.0001) in whom this band was reconstructed around the bladder neck gradually became continent/partly continent with an increase in the dry interval with time. Conclusion It can be a considerable factor to pay attention to the step of wrapping the ISB around the bladder neck during EEC repair. This serves to function as the smooth muscle of the bladder neck as proven histologically in our operated patients. It may have a role to support future continence in these patients.


2017 ◽  
Vol 3 (2) ◽  
pp. 205511691773364
Author(s):  
Matias Ruiz-Drebing ◽  
Fui Yap ◽  
Mayank Seth ◽  
Ruth Dennis ◽  
Elisabet Dominguez

Case summary A 33-month-old, spayed female domestic shorthair cat was referred to the Animal Health Trust for the investigation of urinary incontinence and straining to urinate. A membrane-like structure was detected in the bladder neck, which caused partial obstruction of the urinary bladder. A combination of different imaging techniques, including ultrasonography, radiography, CT and fluoroscopy, was essential in the diagnosis, surgical planning and treatment of this intravesicular stricture. During retrograde vaginourethrocystogram, unexpected subcapsular accumulation of contrast medium was seen around both kidneys on radiographs and confirmed with CT. Three different treatments were performed, including surgical debridement, balloon dilatation and placement of a self-expanding metallic stent across the stricture. Histopathology of the membrane was unable to differentiate whether the lesion was congenital or acquired. No urinary incontinence was observed 5 months after placement of the metallic stent. Relevance and novel information This is the first reported case using fluoroscopic-guided balloon dilatation of the bladder neck for the treatment of a bladder neck stricture. Presence of renal subcapsular contrast medium secondary to a retrograde vaginourethrocystogram due to partial obstruction at the bladder neck in a cat has not been previously described.


2012 ◽  
Vol 40 (S1) ◽  
pp. 180-180
Author(s):  
Z. Leibovitz ◽  
A. Zreik ◽  
S. Degani ◽  
H. Bakry ◽  
I. Shapiro ◽  
...  

2012 ◽  
Vol 31 (5) ◽  
pp. 688-694 ◽  
Author(s):  
José Luis Arteaga ◽  
Luis M. Orensanz ◽  
María Pilar Martínez ◽  
María Victoria Barahona ◽  
Ana Martínez-Sáenz ◽  
...  
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