R. Mund ( Leipzig )  

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10 Years  

Male  

Pelvis-Urinary bladder  

congenital  

A now 10 year-old boy; findings after corrective surgery of a bladder exstrophy in infancy.

With 9 years of age, bladder augmentation with an ileum patch (increase of bladder volume).  

Bladder exstrophy: so-called split bladder. Congenital defect of the front bladder and abdominal wall with free-lying hind bladder wall, the vesical triangle and the hind wall of the urethra.  

<- view Ultrasound 1

Ultrasound 1: Urinary bladder, longitudinal. In the roof of the bladder, one can see the irregularities of the urinary bladder through the ileum.




<- view Ultrasound 2

Ultrasound 2: Urinary bladder, horizontal, Photopic-Mode. On the anterior wall (in the region of the roof of the bladder), a "neo-bladder" can be seen. Increased peristaltic movemntes of the roof of the bladder can be seen.


 

Surgery / Histo  

N/A  

Even though the bladder volume was increased by augmentation, the incontinence remained. The boy was treated with a gracilisplasty at the proximal urethra (after stimulational therapy of the gracilis muscle).  

During the bladder augmentation, a segment of the ileum (with the most mobile localization) is split longitudinally and sewn into the bladder to increase volume.
In using the gracilis muscle, the ipsilateral gracilis muscle is detached, folded over proximally, and looped around the proximal urethra and the tendon. It is consequently anchored periostally.  

N/A  

N/A  

Urinary bladder, augmentation, ileum patch, exstrophy, bladder augmentation, ileum patch, ileal pouch, ileal conduit, bladder exstrophy, child, childhood, pediatric radiology  

R Mund. Urinary bladder after bladder augmentation with ileum patch (state after bladder exstrophy). PedRad [serial online] vol 2, no. 7.
URL: www.PedRad.info/?search=20020705114724