The two most common congenital bladder abnormalities are exstrophy and congenital diverticula. An exstrophic bladder is one that is open to the outside and turned inside-out, so that its inside is visible at birth, protruding from the lower abdomen. A diverticulum is an extension of a hollow organ, usually shaped like a pouch with a narrow opening.
Causes and Symptoms
As with many birth defects, the causes are not well known. Lack of prenatal care and nutrition has been linked to many birth defects; however, beyond the avoidance of known teratogens (anything that can cause a birth defect), there is little prevention possible. Diverticula are more common and less serious.
If left untreated, the person with bladder exstrophy will have no control over urination and is more likely than others to develop bladder cancer. Diverticula, particularly if it causes urine reflux, may lead to chronic infection and its subsequent consequences.
Surgery is necessary and can usually produce successful results. If possible, the surgery must be performed within 48 hours of birth. Prior to surgery, the exposed organs must be protected and all related defects identified and managed. Delay in the surgery leads to the frequent need to divert the urine into the bowel because the partially repaired bladder cannot control the flow. After surgery, the likelihood of infection requires monitoring.
After surgery, ongoing precautions to reduce frequency of infection may have to be used. Cranberry juice has the ability to keep bacteria from adhering to the membranes and can help prevent infection whenever there is increased risk. There are botanical and homeopathic treatments available; however, consultation by a trained practitioner is recommended before treatment.
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