Exstrophy of Bladder
- Exstrophy of bladder is also called as Ectopia Vesicae
- This is a congenital abnormality in which there is incomplete development or absence of the infra-umbilical part of the anterior abdominal wall, associated with incomplete development of the anterior wall of the bladder.
Incidence of Exstrophy of bladder
- Ectopia vesicae are rare and its incidence is one in 50,000 births.
Types of Ectopia Vesicae
Two types are commonly seen
- Complete ectopia vesicae
- Incomplete ectopia vesicae
The complete variety is more common. In incomplete variety the pubic bones are united and the external genitalia are almost normal.
Clinical features of Ectopia Vesicae
- Males are often more affected than females.The ratio is 4:1.
- Due to pressure of the viscera behind it, the posterior wall of the bladder protrudes through the defect. This is deep red in color. Frequently the averted mucous membrane becomes ulcerated and painful. It may undergo cancerous changes and form adeno-carcinoma.
- It bleeds readily.
- When this mucous membrane is gently upwards, paler, wet trigone becomes visible. Effluxes of urine can be seen from the ureteric orifices.
- A line of demarcation becomes obvious between the protruding mucous membrane and the adjacent skin.
- When the exposed bladder wall is pushed behind with the finger the firm edge beneath the junction can be felt as the defect in the abdominal wall.
- There are certain associated abnormalities- like umbilicus is absent, umbilical hernia, rectal sphincter etc. In females clitoris is cleft, pubic bones are separated and there are recurrent attacks of infection.
Complications of Exstrophy of bladder
- The exposed bladder mucous membrane is usually ulcerated and becomes painful.
- Continuous bad odor of urine accompanies the patient.
- Recurrent ascending infection makes the persons life miserable and it is difficult to control such infection.
- Cancerous change may take place at the exposed mucous membrane of the urinary bladder and it may be the ultimate site of an adeno-carcinoma.
- Half of the people die of renal failure.
Treatment for Exstrophy of bladder
- Treatment of choice is operation. First of all diversion of urine has to be performed. Later, after some months the urinary bladder is excised and closure is done. The operation is performed between 4-6yrs of age.
- Diversion of urine into an ileac conduit with excision of the bladder can be performed at 5yrs of age. As problem of infection is less, renal function is better and this is a better operation.
- Recently attempts are being made to reconstruct the bladder and sphincters within the first year of life.
With these treatments for Ectopia Vesicae, corrective measures can be taken to control and improvise the condition of ailing patients.
- Related Topics
- Bladder Wall Thickening: Causes, Treatment for Thick Bladder Wall
- Bladder Polyps Symptoms: Causes, Treatment For Urinary Bladder Polyps
- Bladder Cyst Symptoms: Cyst On Urinary Bladder Treatment
- Male Bladder Infection Symptoms: Bladder Infection Causes, Remedies
- Bladder Infection Relief: Causes And Remedies For Bladder Infection
My elder sister who is 32 years old has Ectopia Vesica, continuous urinary incontinence with the symptoms you have listed. We are used to her smell, her lifestyle. Otherwise, she leads normal life (she is not married), can walk normally. She doesn’t suffer from infections and has a normal menstruation cycle. Can she still undergo a surgery at this age? What are the likely complications and difficulties post surgery? And would she be able to lead a better life after the operation? I need suggestions and whereabouts hospitals that could undertake this surgery.
My grand son was born on 9 / 9 / 10 in the morning at 9.23 am. We came to know that he is suffering with ectopia vesicae. We did the first surgery on 13 / 9 / 10. We were told that the procedure was successful. What precautions should be taken.
I was born in 1962 with incomplete Ectopia Vesicae, like Robin Harman very little was known. My mum gave birth 2 me at home and I was the 5th child, I was left at home for 3 days and my mum was not allowed 2 c me. I was expected 2 die but still alive after 3 days and with my mum’s anger and determination I was taken 2 hospitals.
My mum was told my chance of survival was zero but I proved them wrong! I was born without any sexual organs, no pubic bone. Half a pelvic bone, a form of spine bifida, bowel and kidney problems, I was lucky in the way that my urinary stoma was formed when I was 14 months old. my mum was told I would not live, then that I would never walk, I would not lead any sort of normal life, be in a wheelchair at 18 yrs, never work, id never have a child as it was impossible, not having a pubic bone and deformed pelvic bone, and my life expectancy was 40 tops.
I can honestly say I lead a “normal” life, went 2 a mainstream school, left and started work at 15 yrs old and at 20 I became pregnant against all the odds, I gave birth 10 days early 2 a beautifully perfectly healthy baby girl. I have had a gr8 life and a “normal” one. I am now 48 and my daughter Jade is 27, I have 2 beautifully grandsons and I am still not in a wheelchair!!! I have had 104 Ops in all but Drs are not always right, as I have proved. Life is not always been a barrel of laughs but it’s what you make it that counts.
Be positive and confident in who u are and never be ashamed about having a stoma or other problems that sometimes come with this condition, I know its sometimes hard, and when I got my “bad days” I had 2 remember that sum1, somewhere was having a worse life than me. If I can help in any way, feel free 2 contact me by replying here.
My thoughts r with you and your brother,
SH
I am also a Ectopia vesicae patient and I have to undergo through my last surgery soon. Everything was normal but now I feel like something is stuck in my urinary tract and sometimes, even urine doesn’t comes out. Please help me with some remedies for ectopia vesicae because it is troubling me since last 5 years.
I, too, was born in 1956 with complete ectopic vesicae when little or nothing was accurately known about it.
I had a urinary stoma formed when I was 11 years old – fortunately it is now done much earlier in life than then – and both prior to that, and since, I have been very fortunate to have lived a `relatively normal’ life.
It is a condition, not an affliction. If your brother’s son can get through the initial (and I have no doubt, very substantial) difficulties, and with suitable support from his local hospital, GP, and members of his family, there is no reason why he should not be able to thrive, live a full life, and more importantly still, be very happy.
If you would like me to get in touch with you, I would be more than willing to hear from you, but I suggest that you contact me at my home e-mail address (given above), not as a return response on this e-mail address.
I sincerely hope I can help you recognise that things are not always as grim as they might seem.
All the best
Robin