A team of doctors at Fortis Hospital in Bannerghatta Road, Bangalore successfully treated a 2-month-old Iraqi baby who was suffering from ‘Bladder Exstrophy with episadias.’ It is a congenital condition where most of his lower urinary tract organs were formed outside his body. The complex procedure involved a multi-specialty team of doctors which took 10 hours to treat the rare condition. The team of doctors was led by Dr. Mohan Keshavamurthy, Director, Urology & Transplant Surgeon along with Dr. Mohan Puttaswamy, Reconstructive Orthopedic Surgeon and Dr. Yogesh Kumar Gupta, Consultant, Paediatric Intensive Care Unit (PICU).
While the child grows in the womb, the internal organs are formed. Consequently, muscles and bones envelop the organs for protection. Baby Ameer Hayder Thaey suffered from Bladder Exstrophy with episadias abnormality where the skin over the lower abdominal wall is not formed properly. The organs are partially formed but the encasing tissues and bones that leaves the bladder exposed. With episadias, the urethra does not form correctly. Babies with this disorder may have related problems that affects their urinary system and pelvic bones.
The priority was to naturalize the functioning of the bladder by closing the bladder with adequate capacity and urethra with restoration of continuous mechanism. Closure of muscle and skin could have been only completed after the bladder was successfully closed. The muscles were closed over the bladder so it supports the abdominal wall.
Dr. Mohan Keshavamurthy, Director, Urology & Transplant Surgeon at Fortis Hospital, BG Road said, “Ameer was born with his urinary bladder exposed outside of his body due to the incomplete formation of the tissues and bones in the pelvic region. The bladder, muscles and bones had defects which needed to be corrected. So, the procedure for treatment involved following a meticulously planned sealing of the entire bladder and penile area.”
Once the bladder is ably supported by muscles, the bones were aligned back together. Finally, the skin was closed in such a way that the bone is in between the skin and muscle, so that the bone can support the bladder. The surgery for episadias, which is a malformation of the penis causing the urethra to be formed on the upper part of the penis, was done by reconstructing the penis by Cantwell Ransley procedure.
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