Doctors at Fortis Hospital successfully treat rare congenital disorder ‘Bladder Exstrophy’

Bangalore, 4 January, 2017: 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 thebladder 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 skinand muscle, so that the bone can support the bladder. The surgery forepisadias, which is a malformation of the penis causing the urethra to beformed on the upper part of the penis, was done by reconstructing the penis byCantwell Ransley procedure

Dr.Mohan Puttaswamy,Reconstructive Orthopaedics Surgeon, said, “We had to create space foraccommodating the urinary bladder in the pelvis. This was done by fracturingthe bones through a procedure known as osteotomy. After fracturing the bones,the baby was put on a fixator to hold the pelvis in place.”  

Speaking onthe recovery of the patient post-surgery, Dr. Yogesh Kumar Gupta,Consultant PICU, Department of Paediatrics said, “Post surgery, Ameerneeded utmost amount of care for a swift and healthy recovery. Given thecomplexity, there was a chance that the kidney may have failed to perform.However, the treatment went smoothly as the baby responded well to thetreatment and post-operative care at the PICU. The baby has recoveredcompletely and, now on, will be leading a normal life.”

Ameer’sgrandfather, said, “When Ameer was born, we noticed that he was passingurine through his belly. We wanted to seek treatment immediately. However, wecould not get proper medical care. Once we get to know about expertise ofFortis Hospitals in treating such babies, we immediately came down to the cityfor treatment.”

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