Diagnosis of epispadias and bladder exstrophy
Last reviewed: 23.04.2024
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Conventional ultrasound diagnosis of the fetus reveals an exstrophy of the bladder in the early stages of pregnancy. Only the extreme rarity of this anomaly and the lack of special precautions complicate the prenatal diagnosis of bladder exstrophy in our country. The specialist of ultrasound diagnostics must see the filled bladder of the fetus at least once during the observation of the pregnant woman. Absence of a normal bladder on ultrasound in combination with education in the abdominal wall with a low position of the navel indicates the presence of exstrophy. Careful examination of the site of the umbilical cord withdrawal helps to conduct differential diagnosis between bladder exstrophy, umbilical hernia and gastroschisis.
The diagnosis of bladder exstrophy is usually put right after the birth of a child. The manifestations of the pathology are very vivid, and with classical bladder exstrophy the diagnosis is obvious. However, since this anomaly is relatively rare, the identification of sex and the definition of the localization of organs such as the vagina, the clitoris. Rudimentary penis, usually require an examination and examination of the child by a specialist.
Combined anomalies in patients with classical exstrophy of the bladder are rare, however, special attention should be paid to the examination of the heart, lungs, lumbar spine.
The prognosis of the disease and the effectiveness of subsequent bladder growth and the ability to retain urine depend in part on the size of the vesicle pad. It is important to determine the length and width of the vesicle pad, assess the condition of the mucous membrane of the bladder, especially if the child is not newborn. If a plastic terminal is applied to the remainder of the umbilical cord, it should be removed, replaced with a ligature. Bubble is better to close with a perforated polyethylene film, and only then with a diaper or diaper. Never use gauze and petroleum jelly, as they dry and injure the epithelium of the mucous membrane of the bladder.
Boys need to measure the size of the penis. The developmental disorder of the reproductive organs may vary from relatively mild in epispadias to severe in cloacal exstrophy. It is important to identify the testicles palpably. They can be located in the scrotum or in the inguinal canal. In rare cases, cryptorchidism is detected. In the presence of inguinal hernia it is necessary to diagnose epispadias and bladder exstrophy. Girls usually have one or two vaginal openings that are located directly under the exposed urethra.
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