Bladder exstrophy: post-surgery

Case contributed by Dr Jayanth Keshavamurthy

Presentation

Patient with history of bladder exstrophy with appendico- vesicostomy. A history of chronic kidney disease with baseline serum creatinine 1.7-1.9 due to obstructive uropathy. Congenital exstrophy of bladder, status post multiple abdominal surgeries including neobladder reconstruction requiring self catheterization, recurrent UTIs and hydronephrosis. Patient presents with abdominal pain.

Patient Data

Age: 30-35
Gender: Male
X-ray

KUB exam of abdomen

Severe pubic symphysis diastasis from known urinary bladder exstrophy. Think of other causes of widened pubic diastasis in mind like trauma, Prune Belly syndrome, etc.

Urinary bladder absent.

Widened pubic symphysis from exstrophy.

Post surgical changes from appendico-vesicostomy.

See where the portion of bowel is brought to the surface of abdomen in midline for self catheterisation.

Case Discussion

The goals of surgery are to close the bony pelvic ring, close the bladder, posterior urethra and close the anterior abdominal wall defect and reconstruct the genitalia.

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Case information

rID: 35763
Case created: 21st Apr 2015
Last edited: 6th Nov 2017
Inclusion in quiz mode: Included

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