Escutcheon and External Genitalia Reconstruction following Childhood Correction of Urinary Bladder Exstrophy

Bladder exstrophy or ectopia vesica is an unusual congenital anomaly which exists in the spectrum of the exstrophy- epispadias complex. It most commonly involves protrusion of the urinary bladder due to defect in the lower abdominal wall. It has variable presentation and often includes abnormalities of the pelvic floor, bony pelvis and genitalia. Patients undertaking pregnancy after surgical repair of such an anomaly are rare. Planned Cesarean section at term is considered the appropriate mode of delivery. We present a case of 21-year-old patient who had uneventful preterm vaginal delivery following surgical repair of bladder exstrophy in childhood.

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Advances in bladder substitution and creation of neobladders in children

F1000Research ◽

10.12688/f1000research.16607.1 ◽

2019 ◽

Vol 8 ◽

pp. 1992

Author(s):

Jennifer E. Reifsnyder ◽

Moneer K. Hanna

Keyword(s):

Urinary Bladder ◽

Pediatric Population ◽

Surgical Techniques ◽

Bladder Exstrophy ◽

Bladder Substitution

Cystectomy and urinary bladder substitution are rare in children but may be necessary in some cases of bladder exstrophy, in the setting of malignancy, or in other settings in which the bladder is severely dysfunctional. This article details advances in surgical techniques in creating continent urinary diversions in this specialized pediatric population.

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Primary urinary bladder adenocarcinoma with vaginal invasion

Revista médica (Colegio de Médicos y Cirujanos de Guatemala) ◽

10.36109/rmg.v160i3.400 ◽

2021 ◽

Vol 160 (3) ◽

pp. 322-324

Author(s):

Eugene Velásquez ◽

Emerson De-la-Rosa ◽

Lourdes Herrera ◽

Lucía Solé

Keyword(s):

Urinary Bladder ◽

Female Patient ◽

Bladder Exstrophy ◽

Vaginal Wall ◽

Bladder Tumors ◽

Pelvic Lipomatosis ◽

Chronic Irritation ◽

Bladder Adenocarcinoma ◽

Wall Invasion

Primary urinary bladder adenocarcinoma is not a common tumor, it comprises between 0.5 and 2% of all bladder tumors. It has been linked to bladder exstrophy, chronic irritation, and pelvic lipomatosis. Next, the case of a 62-year-old female patient with primary urinary bladder adenocarcinoma and vaginal wall invasion is presented.

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Bladder Exstrophy

10.1093/med/9780190685157.003.0040 ◽

2018 ◽

Author(s):

Jason Bryant

Keyword(s):

Fetal Development ◽

Bladder Exstrophy ◽

External Genitalia ◽

Rare Condition ◽

Pelvic Girdle ◽

Urinary Continence ◽

Improve Quality ◽

Risk Of Infection ◽

Pelvic Stabilization

Bladder exstrophy is a rare condition in which there is an error in fetal development leaving the bladder and pelvic structure malformed. The bladder, pelvic girdle, and external genitalia are often split, requiring repair. The goals of this repair are to improve quality of life in terms of urinary continence, aesthetics, pelvic stabilization, and sexual function. This repair often requires prolonged traction and external fixation to adequately fuse the pelvic girdle. To aid in the healing and tolerance of this, a prolonged epidural catheter is often used. The pharmokinetics and risk of infection are major considerations during the prolonged use of a caudal catheter.

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Adenocarcinoma of the Urinary Bladder

Archives of Pathology & Laboratory Medicine ◽

10.5858/arpa.2009-0713-rs ◽

2011 ◽

Vol 135 (12) ◽

pp. 1601-1605 ◽

Cited By ~ 19

Author(s):

Somak Roy ◽

Anil V Parwani

Keyword(s):

Urinary Bladder ◽

Bladder Exstrophy ◽

Therapeutic Options ◽

Primary Adenocarcinoma ◽

Metastatic Adenocarcinoma ◽

Clinical Imaging ◽

Diagnostic Confusion ◽

Primary Bladder ◽

Degree Of Differentiation ◽

Uncommon Neoplasm

Primary adenocarcinoma of urinary bladder is an uncommon neoplasm and is a source of diagnostic confusion with adenocarcinomas arising in adjacent organs, especially colon. These tumors show varied histologic picture and degree of differentiation. Clinical association with bladder exstrophy and schistosomiasis has been well documented. Primary bladder adenocarcinomas have overlapping histologic and immunohistochemical features with adenocarcinomas arising from other primary sites and the suggested immunohistochemical panel includes cytokeratins 7 and 20, 34βE12, thrombomodulin, CDX2, and β-catenin. Clinical, imaging, histologic, and immunohistochemical correlation should be done while rendering this diagnosis, as prognosis and therapeutic options for primary versus metastatic adenocarcinoma vary widely.

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Extraordinary Bulging Mass in the Foetus - A Case Report of Bladder Exstrophy

Prenatal Cardiology ◽

10.1515/pcard-2018-0007 ◽

2018 ◽

Vol 8 (1) ◽

pp. 48-52

Author(s):

Joanna Łosińska ◽

Maria Respondek-Liberska

Keyword(s):

Case Report ◽

Good Condition ◽

Bladder Exstrophy ◽

External Genitalia ◽

Posterior Wall ◽

Anterior Wall ◽

Abnormal Development ◽

Normal Limits ◽

Incomplete Closure ◽

Tract Infections

Abstract INTRODUCTION: Prenatal diagnosis of bladder exstrophy is extremley rare and difficult. BACKGROUND: Due to abnormal development of the cloacal membrane there is an incomplete closure of the lower abdominal wall, absence of the anterior wall of the bladder and external exposition of the posterior wall. The pubic bones are usually separated, the umbilical cord low inserted and there is abnormal external genitalia development. CASE REPORT: At 21st week of gestation of 39-year-old multigravida multipara referred by a primary care obstetrician to high-specialised centre for a detailed ultrasound examination with a suspicion of bladder absence and inferior umbilical localisation. At 29 weeks of gestation presence of bulging mass of 2 cm, between the umbilical outlet and labia was detected. At 31 weeks of gestation previously detected structure among thighs had 3 cm diameter with lateral umbilical outlet. Major labia were prominent and minor labia were within normal limits. Between two umbilical arteries with an appropriate intraabdominal course there were no transsonic area corresponding to the urinary bladder. The newborn baby was born at term in a good condition, but with an exposed bladder of 4 cm in diameter. The urethral outlet was not visualised and the female genitals were abnormal. After a month the girl underwent primary bladder exstrophy closure. Although she suffers from recurring urinary tract infections, she is in a good general condition. CONCLUSIONS: Due to prenatal diagnostics it was possible to detect and make an initial diagnosis of severe malformation. Early diagnosis allowed to prepare parents for a newborn with a defect and teach them how to take care of the baby.

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