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Urology
Bladder Reconstruction
Bladder reconstruction is often necessary in children and young adults born with congenital abnormalities such as bladder exstrophy, posterior urethral valves, and neurogenic bladder secondary to a multitude of conditions, the most common being spina bifida. The Division of Pediatric Urology has a large database of bladder exstrophy patients that was started by Dr. John K. Lattimer continuing through to the present.
Recently, the experience of the Hospital's pediatric urologists with bladder exstrophy has been published, looking for the first time at the long-term effects on the life and lifestyle of patients born with this devastating anomaly. The bladder exstrophy database has more than 300 patients, and our physicians are actively looking into the 25-year follow-up of both primary closure and continent urinary diversion in this group of individuals. In addition to the obvious advantage of having a large number of patients in the database, it makes networking between older patients and new patients something that is uniquely possible in our institution.
Bladder reconstruction is also necessary on occasion in patients born with other congenital abnormalities in the lower urinary tract, including posterior urethral valves (PUVs). PUVs can destroy the bladder and make continent urinary diversion and/or bladder augmentation necessary. In addition, patients born with neurogenic bladder secondary to spina bifida are often candidates for bladder reconstruction. Morgan Stanley Children's Hospital physicians have a long experience not only with continent urinary diversion, but also with the use of MACE procedure for management of neurogenic bowel dysfunction in patients with spina bifida.
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