Types of surgery in exstrophy of the bladder, Biology

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Types of Surgery 

There may be two options for surgical correction. Urinary Diversion In this following procedures are performed: 

1)  Uretero sigrnoidostomy  if there  is no anal incontinence 

2)  Illeal conduit 

3)  Colonic conduit with entire flux  procedure. 

Primary Reconstruction of Bladder 

In this  following  steps are  followed. 

a)  At birth-bladder  closure or  "Turning  in" without  the repair of bladder neck is done and abdominal wall is closed over  the rotational flaps. 

b)  At 2-3 years of age: Chordae correction. Elongation of penis and Ducket's para extrophy  flaps are raised.  In this bladder neck is receded into pelvis. Following this  repair of bladder neck and entire flux  procedure is also done. 

c)  If continence is achieved and upper urinary tracts are normal, repair of epispadias is  done. 

d)  If continence is good but child is dry only for short intervals, then at the age of 7-8 years  augmentation of bladder capacity is done by colocystoplasty. 

Postoperative care includes monitoring of vital signs,  combating shock and watch and prevent bleeding  from operation site. Position the child in such a way so  as to prevent kinking of any drainage tubing. 

  1. Keep abdominal dressing clean and dry. 
  2. Maintain adequate fluid  intake. 
  3. Watch for fever, hematuria  or purulent drainage  from  the incision. 

All these activities  should be performed with involvement of parents  so  that they can do this at home after discharge.  


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