After doctors make the diagnosis, your child may have surgery to:
- Bring the pubic bones together in front
- Place the bladder into the pelvic cavity
- Tighten the muscles where the bladder connects to the urethra to improve control of urine flow
- Fix the tube (urethra) that carries urine from the bladder to the outside of the body if it is short and split (epispadias)
- Close the wall of the belly (abdominal wall)
- Create an opening from the intestines to outside the belly wall so poop (stool) can come out (the surgery is called a colostomy)
For young babies, we do all these steps in a single surgery (complete primary repair), 3 to 4 months after birth. An orthopedic surgeon closes the pubic bones, and a urologist completes the other steps.
Doing everything at once is more complex than surgery in stages over several years. But 1-stage repair means your child will have better outcomes. The bladder is more likely to grow to normal or nearly normal size, giving your child more control over urine flow. Even so, 50% to 60% of children will need more surgery later in childhood. Your child may need surgery to help improve bladder control or stop backflow of urine from the bladder to the kidneys (vesicoureteral reflux).