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Extraordinary Bulging Mass in the Foetus - A Case Report of Bladder Exstrophy

References 1. Reinfeldt Engberg G, Mantel A, Fossum M, Nordenskjold AG. Maternal and fetal risk factors for bladder exstrophy: a nationwide Swedish case-control study. J Pediatr Urol 2016; 12:304.e1-304.e7. 2. Gambhir L, Holler T, Muller M, et al. Epidemiological survey of 214 families with bladder exstrophy-epispadias complex. J Urol2008; 179: 1539-1543. 3. Siffel C, Correa A, Amar E, et al. Bladder exstrophy: an epidemiologic study from the International Clearinghouse for Birth Defects Surveillance and

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Long Term Follow Up of Complete Bladder Exstrophy Repair. A Case Report

References 1. Epidemiology of bladder exstrophy and epispadias: a communication from the International Clearinghouse for Birth Defects Monitoring Systems. Teratology 1987;36:221. 2. Shapiro E, Lepor H, Jeffs RD. The inheritance of the exstrophy-epispadias complex. J Urol 1984;132:308. 3. Nelson CP, Dunn, RL, Wei JT. Contemporary epidemiology of bladder exstrophy in the United States. J Urol 2005;173:1728. 4. Mitchell M, Grady R. Bladder and cloacal exstrophy. In: Holcomb GW III, Murphy JP

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Diagnostic and Surgical Approach to Prenatally Detected Urinary Tract Anomalies

Abstract

Regular ultrasound examinations carried out in the second trimester of pregnancy help in detecting many anomalies in the fetal urinary tract. Their percentage ranges from 1% to 3% of all controlled pregnancies. There is a wide spectrum of anomalies that affect the urinary tract, but the most significant are: uretero/hydronephrosis (unilateral or bilateral), kidney agenesis, dysplastic kidney, polycystic and multicystic kidneys, anomalies of ascent, anomalies of kidney rotation or fusion, bladder exstrophy, posterior urethra valve etc.

Many of these anomalies do not have impact either on urine flow or on kidney function and hence they can be qualified rather as a condition than as a disease. At the same time, most of the hydronephroses that are seen prenatally are being resolved spontaneously, and they are not detected neither presented postnatally as uretero/hydronephroses of unobstructed type and do not require surgical treatment. Only one tenth of these anomalies are subject to active surgical treatment.

Therefore, the assessment of these conditions should be done by a specialized team, who will make adequate therapeutic decisions based on clinical guidelines, as well as will advise the parents on the future clinical implications of the detected anomaly.

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