Bladder Exstrophy

Bladder exstrophy is a congenital anomaly characterized by extrusion of the urinary bladder to the outside of the body through a defect in the lower abdominal wall. The cause of bladder exstrophy is unknown.

Bladder exstrophy needs a surgical management and a series of staged reconstructions. The initial surgery is to close the abdominal defect, and it should be done within the first few day of life. However, the subsequent operation is done to reconstruct the bladder and genitalia and enable child to achieve urinary continence.

Signs and Symptoms of Bladder Exstrophy:

• Esposed bladder mucose
• Widened symphysis pubis
• Defects of the external genitalia

Nursing Interventions:

• Monitor urinary output
• Monitor for signs of urinary tract or wound infections
• Maintain the integrity of the exposed bladder mucose
• Prevent the bladder tissue from drying, while allowing the drainage of urine until surgical closure is done.
• Cover the bladder with sterile, nonadherent clear plastic wrap or a sterile thin film dressing without adhesive
• Petroleum jelly is avoided because it tends to dry out, adhere to the bladder mucose, and damage the delicate tissues when the dressing is remove
• Administer antibiotics as prescribed
• Emotional support to the parents and encourage verbalization of their fears and concerns