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Bladder exstrophy, abnormalities of the male urethra, and webbed penis

Last updated: January 8, 2021

Summary

Bladder exstrophy is a rare condition caused by an embryonal malformation resulting in failed closure of the anterior abdominal wall and an exposed urinary bladder. Surgery, which involves bladder and abdominal wall closure, is necessary and should be performed within the first days of life. Even with early treatment, life-long care is needed to prevent further complications. Abnormalities of the male urethra, on the other hand, are common and the need for treatment depends on the condition and the symptoms. Epispadias and hypospadias may result in difficulty urinating and infections, and surgical repair is indicated for restoring functionality and reconstruction of external genitalia. Posterior urethral valves are the most common cause of urinary obstruction in newborn boys and can be associated with hydronephrosis, renal failure, and pulmonary hypoplasia. Early identification by prenatal ultrasound with diagnosis by voiding cystourethrogram allows for cystoscopic valve ablation and relief of the obstruction. However, despite treatment, many patients will develop chronic kidney disease.

Bladder exstrophy

Epispadias

Hypospadias

Circumcision is contraindicated in hypospadias!

Posterior urethral valves

Webbed penis

  • Definition
  • Clinical features
  • Diagnostics: clinical diagnosis
  • Treatment
    • Early surgical correction with suturing of the scrotum to the penile shaft
    • Generally for cosmetic reasons

References:[6]

References

  1. No authors listed. Epidemiology of bladder exstrophy and epispadias: a communication from the International Clearinghouse for Birth Defects Monitoring Systems.. Teratology. 1987; 36 (2): p.221-7. doi: 10.1002/tera.1420360210 . | Open in Read by QxMD
  2. Penile and Urethral Anomalies. http://www.merckmanuals.com/professional/pediatrics/congenital-renal-and-genitourinary-anomalies/penile-and-urethral-anomalies. Updated: November 1, 2016. Accessed: April 12, 2017.
  3. Baskin LS, Himes K, Colborn T. Hypospadias and endocrine disruption: is there a connection?. Environ Health Perspect. 2001; 109 (11): p.1175-83. doi: 10.1289/ehp.011091175 . | Open in Read by QxMD
  4. El-Koutby M, Mohamed Amin el G. Webbed penis: A new classification. J Indian Assoc Pediatr Surg. 2010; 15 (2): p.50-52. doi: 10.4103/0971-9261.70637 . | Open in Read by QxMD
  5. Brownlee E, Wragg R, Robb A, et al. Current epidemiology and antenatal presentation of posterior urethral valves: Outcome of BAPS CASS National Audit.. J Pediatr Surg. 2019; 54 (2): p.318-321. doi: 10.1016/j.jpedsurg.2018.10.091 . | Open in Read by QxMD
  6. Reinfeldt Engberg G, Mantel Ä, Fossum M, Nordenskjöld A. Maternal and fetal risk factors for bladder exstrophy: A nationwide Swedish case-control study.. J Pediatr Urol. 2016; 12 (5): p.304.e1-304.e7. doi: 10.1016/j.jpurol.2016.05.035 . | Open in Read by QxMD