Duplicate Bladder Exstrophy With Fistula: A Rare Variant of Exstrophy-Epispadias Complex

Bijay Thapa

doi:10.3126/jnps.v41i2.30752

Abstract

Variants of exstrophy are rare anomalies seen in the spectrum of bladder exstrophy-epispadias complex. A seven day old male neonate was admitted in our department with a rare variant of duplicate bladder communicating with exstrophy bladder with fistula. Patient presented with patch of exstrophic bladder just below the low set umbilicus with a normal sized phallus and normally positioned urethral meatus. The baby was managed successfully with surgery and is under regular follow up.

Highlights

Bladder exstrophy is a rare malformation occurring predominantly in males, with an incidence of1:50,000 live births.[1]
We report a rare variant of duplicate exstrophy with a fistula between the exstrophy bladder and normal abdominal bladder in a male neonate
Exstrophy variants can be categorised as duplicate exstrophy, superior vesicle fistula, pseudo exstrophy and covered exstrophy

Summary

INTRODUCTION

Bladder exstrophy is a rare malformation occurring predominantly in males, with an incidence of. A seven day old male neonate with birth weight 3 kg was admitted in our surgical ICU with an obvious urogenital abnormality. He was born to 23 years old mother with full term normal vaginal delivery with no significant antenatal and family history. There was a mucosal extension along the dorsum of penis which appeared to be epispadias urethra of exstrophied bladder and mild dorsal chordee was present (Figure 1). His postnatal ultrasound demonstrated normal kidneys, ureters and bladder, beneath exstrophied bladder patch. The ultrasonography and micturating cystourethrogram at six months of age showed normal bladder with normal upper urinary tracts

DISCUSSION

Findings

CONCLUSIONS