Bladder Exstrophy Repair

Written by Karla Blocka
Medically Reviewed by George Krucik, MD

What Is a Bladder Exstrophy Repair?

Bladder exstrophy repair is a surgical method of repairing a birth defect in which the bladder grows outside the abdominal wall. In infants who have this condition, the bladder, and sometimes other organs, are on the outer surface of the body. Other names for the procedure are:

  • bladder birth defect repair
  • everted bladder repair
  • repair of bladder exstrophy
  • exposed bladder repair

Definition of Bladder Exstrophy

Bladder exstrophy is a birth defect. The abdominal wall and organs do not form correctly during fetal development. This causes the bladder to stick out of the abdomen. The pubic bones also separate.

The condition varies in severity. It is seen more often in boys than girls. According to Boston Children’s Hospital, it affects approximately one in 40,000 infants. (BCH)

Bladder exstrophy is also associated with a number of other defects. These include:

  • muscles that are weakened and misshapen in the lower abdominal wall
  • widening of the pubic bones
  • displaced belly button
  • short urethra, wide-spread labia, and narrow vaginal opening (girls)
  • shortened penis (boys)
  • legs and feet that are rotated outward

Bladder exstrophy happens early in fetal development. The cause is not known.

Why Is Bladder Exstrophy Repair Necessary?

Bladder exstrophy repair is used to move exposed abdominal organs, such as the bladder, back into the abdomen. .

This is necessary for:

  • development of urinary control
  • avoidance of future sexual function problems
  • improvement of physical appearance
  • prevention of infection

Usually this surgery is done a few days after birth. However, the bladder needs to be big enough for surgery. If it is not, the surgery can be postponed. In such cases, the newborn baby is sent home with antibiotics. You will also be taught how to keep the bladder from becoming dry.

Preparation for Bladder Exstrophy Repair

This procedure is usually performed before a newborn leaves the hospital. The hospital staff will perform all necessary preparations.

If the surgery is postponed, however, tests may be needed. These include:

  • urine tests to check for infection and kidney problems
  • blood tests
  • lower abdomen and pelvic X-rays
  • kidney ultrasounds

You may also need to keep a record of how much urine your child is producing.

In the 10 days leading up to the surgery, the doctor may ask your child to stop taking any medications that affect blood clotting. These medications include aspirin, warfarin, and ibuprofen.

Be sure to tell the doctor about all medications your child is currently taking, including over-the-counter drugs. Ask which, if any, should be taken on the day of the surgery.

The doctor will most likely ask that your child not eat or drink anything in the hours leading up to the surgery. However, any necessary medication can be given with a little bit of water.

Your doctor will let you know when your child should arrive for the surgery.

How Is a Bladder Exstrophy Repair Performed?

Bladder exstrophy repair requires two separate surgeries. The first surgery repairs the bladder. The second repairs the attachment between the pelvic bones.

In the first surgery, the exposed bladder is separated from the abdominal wall. Then, the bladder is closed. The neck of the bladder and the urethra are repaired. A hollow tube called a catheter is placed in the bladder so urine can be drained through the wall of the abdomen. Another catheter is placed to drain urine from the urethra. This promotes healing.

In the second surgery, the pelvic bone attachment is repaired. This may be done either right after the bladder repair or at a later time.

More surgeries may sometimes be needed. This is particularly true if there is a defect in the bowel.

What Happens After Bladder Exstrophy Repair?

After the surgery, the infant will probably have to stay in the hospital for four to six weeks. During the first three to four weeks the infant will have a catheter running from the bladder through the abdominal wall. This is used to drain urine.

Because surgery separated the pelvic bones, a cast or sling will be needed on the child’s lower body to promote healing. It will be in place for four to six weeks.

Wound care, pain management, and antibiotics will be used as needed.

Urine samples will need to be checked at follow-up appointments. This is an easy way to detect any infection from the procedure.

Benefits of Bladder Exstrophy Repair

When successful, the surgery results in:

  • urinary control
  • improved appearance of the genitals
  • reduced problems with future sexual functioning
  • prevention of kidney and other infections

However, the procedure is not always successful. Sometimes surgeries may need to be repeated.

In some cases, urinary control is never achieved. A catheter may be needed intermittently for the rest of the child’s life. .

Risks of Bladder Exstrophy Repair

Risks associated with the repair include:

  • inadequate urinary control, or incontinence
  • urinary tract infections
  • problems with sexual function
  • problems with kidney function
  • need for further surgeries

However, these problems are less likely than if a repair is not attempted.

In addition to these risks, there are risks associated with the use of anesthesia. These include problems breathing and adverse drug reactions.

Every surgery carries a risk of bleeding and infection.

Was this article helpful? Yes No

Thank you.

Your message has been sent.

We're sorry, an error occurred.

We are unable to collect your feedback at this time. However, your feedback is important to us. Please try again later.

Show Sources

Trending Now

Numbness, Muscle Pain and Other RA Symptoms
Numbness, Muscle Pain and Other RA Symptoms
The symptoms of RA are more than just joint pain and stiffness. Common symptoms include loss of feeling, muscle pain, and more. Learn more in this slideshow.
Timeline of an Anaphylactic Reaction
Timeline of an Anaphylactic Reaction
From first exposure to life-threatening complications, learn how quickly an allergy attack can escalate and why it can become life threatening.
How to Evaluate Your Multiple Sclerosis Treatment Plan
How to Evaluate Your Multiple Sclerosis Treatment Plan
Every multiple sclerosis (MS) patient is different, and no single treatment plan works for everyone. Learn more about what to consider when evaluating your MS treatment plan.
Migraine vs. Chronic Migraine: What Are the Differences?
Migraine vs. Chronic Migraine: What Are the Differences?
There is not just one type of migraine. Chronic migraine is one subtype of migraine. Understand what sets these two conditions apart.
Beyond Back Pain: 5 Warning Signs of Ankylosing Spondylitis
Beyond Back Pain: 5 Warning Signs of Ankylosing Spondylitis
There are a number of potential causes of back pain, but one you might not know about is ankylosing spondylitis (AS). Find out five warning signs of AS in this slideshow.