exstrophy of bladder/ urinary bladder extrophy.pptx

exstrophy of bladder/ urinary bladder extrophy

1. urinary bladder exstrophy /EXSTROPHY OF BLADDER PRESENTED BY: M.C.KNIRANDA ASSISTANT PROFESSOR SSNSR, SU.

2. introduction It is also termed as ‘ Ectopic vesicae ’ Exstrophy means ‘ turned inside out ’. Bladder exstrophy is a congenital abnormality of the bladder . Associated with numbers of congenital anomalies, related to Urogenital tract, Musculo - skeletal system and sometimes of GI system.

3. definition Exstrophy of bladder is a congenital malformation in which lower portion of the abdominal wall does not form properly and the anterior wall of the bladder is missing, so the bladder is open and exposed on the outside of the abdomen.

4. incidence 1 in every 50,000 live births. It is rare congenital abnormality. Males are affected 2-3 times more often than females.

5. In boys born with bladder exstrophy, the bladder is on the outside of the body and the penis and urethra are not fully closed

6. In girls born with bladder exstrophy, the bladder is on the outside of the body and the vagina is not fully formed

7. ETIOLOGY Idiopathic Due to any birth defect Use of assisted reproduction F amily history Environmental factors

8. DIAGNOSIS Fetal Ultrasound Cystoscopic examination ( a surgical procedure that allows a healthcare provider to examine the urinary tract, including the bladder, urethra, and ureters, to help identify problems) X-Ray USG IVP Urodynamic testing ( any procedure that looks at how well parts of the lower urinary tract) Clinically obvious at birth

9. SURGICAL MANAGEMENT 1. MSRE – ( Modern Staged Repair of Exstrophy ) Staged repair involves three operations. First procedure closes the bladder and the abdomen - within 72 hours after birth Second procedure, repairs the urethra and sex organs . - age 6 to 12 months Third procedure, when the child is old enough to participate in toilet training, surgeons perform bladder neck reconstruction - 4 to 5 years.

10. SURGICAL MANAGEMENT 2. CPRE – Complete Primary Repair of Exstrophy Complete repair surgery is performed in a single procedure that closes the bladder and the abdomen and repairs the urethra and outer sex organs. This can be done soon after birth , or when the baby is around two to three months old.

11. NURSING MANAGEMENT Limit trauma to the surgical site Monitor for infection Apply non adherent film dressing Wound care Monitor urine output Psycosocial assistance

12. THANK YOU