Kidney, Reproductive and Urinary Conditions

Bladder Exstrophy Symptoms and Diagnosis

Symptoms of Bladder Exstrophy

The symptoms and signs of bladder exstrophy depend on how severe it is and if other organs are involved. Children with bladder exstrophy may have some or all of these defects:

  • Epispadias – The urethra may be short and split. In boys, it opens on the upper surface of the penis. The split may also involve the two halves of the testicles. In girls, the urethra opens between a split clitoris and the inner flaps of skin around the opening of the vagina (labia minora).
  • Chordee – In boys, the penis may curve up.
  • Bladder neck and sphincter that aren’t complete – The bladder neck is the lower part, or door, of the bladder. The sphincter is a ring of muscles around the bladder neck. These parts control urine flow when they open and close. If they aren’t complete, your child’s bladder cannot hold in urine.
  • Small bladder – The bladder may hold less urine than normal causing frequent urination or leaking.
  • Vesicoureteral reflux – Urine travels from the kidneys down tubes called ureters into the bladder. Normally, this flow is one way. In vesicoureteral reflux, urine can flow back up from the bladder to the kidneys.
  • Diastasis – The left and right sides of the pubic bone in the pelvis may be wide apart instead of meeting in the front.
  • Spinal lipoma – Some children with a more severe form of exstrophy that affects the urethra, bladder, genitals and bowel (cloacal exstrophy) may have a fatty growth (lipoma) on their spinal cord. This may cause problems with their legs, bladder and rectum.
  • Kidney problems – Some children may have double kidneys or kidneys not in the usual place.
  • Bowel problems – Children with cloacal exstrophy may have bowels that are large, not well developed and without a rectum. They usually need surgery to make an opening from the intestines to outside the stomach so poop (stool) can come out. This surgery is called a colostomy.

Bladder Exstrophy Diagnosis

Sometimes exstrophy is diagnosed when a pregnant woman has an ultrasound

The ultrasound doctor (radiologist) might notice the baby’s bladder is not full. But unborn babies pee often, making the bladder hard to see, and it is easy to miss seeing exstrophy. That is why many babies are diagnosed after they are born.

The defect is usually diagnosed right after birth. But sometimes the diagnosis is not made right away, because this is a rare defect that most healthcare providers have not seen before. Sometimes, it will take a specialist to confirm the diagnosis and to tell if the baby is a boy or a girl.

Your child’s doctor might use imaging tests, like ultrasound, to learn more about your child’s organs and how they are affected.