A Case Report on A Rare Variant of a Common Anomaly – Covered Bladder Exstrophy
Iranian Journal of Pediatric Surgery,
Vol. 11 No. 1 (2025),
20 May 2025
,
Page 130-140
https://doi.org/10.22037/irjps.v11i1.47037
Abstract
Abstract
Background: Variants of bladder anomalies are rare and often associated with other
abnormalities of the genitourinary system. Covered bladder exstrophy, a rare variant
within the exstrophy-epispadias complex, is one such example.
Case Presentation: We report a case of a 2-year-old female presenting with covered
exstrophy of the bladder. The patient exhibited intermittent swelling over the anterior
abdominal wall since birth, which increased in size during urination. Examination
revealed a midline abdominal wall defect covered by skin in the hypogastric region.
Diagnostic imaging, including a micturating cystourethrogram and ultrasound,
confirmed the presence of an anterior abdominal wall defect with diastasis of the
pyramidalis muscle and a focal bladder mucosal defect with intact detrusor muscle
continuity.
Intervention: Surgical exploration revealed a smooth, globular structure with thinned
walls and a vascular appearance herniating through the defect, confirmed to be the
urinary bladder. Primary repair was performed, augmented with an onlay mesh
hernioplasty using a polypropylene mesh.
Outcome: The intraoperative period was uneventful, and the patient was alert and
active postoperatively. Follow-up showed no complications, and the patient exhibited
normal urinary function.
Conclusion: This case highlights the importance of early diagnosis and surgical
intervention in managing covered bladder exstrophy. The successful repair of the
defect and the favorable postoperative outcome underscore the efficacy of the surgical
approach used.
- Bladder extrophy
- pediatric bladder anomalies
- ultrasound
How to Cite
References
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