Extrophio vesicae urinariae
Sažetak
Ekstrofija mokraćne bešike je teška i retka kongenitalna malformacija. Javlja se u tri klinička oblika: inkompletna, kompletna ili klasična (extrophio - epispadio complex) i treća, najteža, kloakalna ekstrofija, koja je često inkopatibilna sa životom zbog pridruženosti sa anomalijama drugih organskih sistema.
Iako je modernizacija ultrazvučnih aparata omogućila veliki napredak u dijagnostici, a veliki broj kontrola i adekvatan nadzor trudnice, postoje i danas posebne okolnosti kada je limitirana vizualizacija fetusa. Važno je, međutim, vešto voditi porođaj bez dodatnih akušerskih komplikacija kao i da neonatološko zbrinjavanje deteta bude adekvatno jer od njegove vitalnosti (osim od same anomalije) zavisi i krajnji operativni ishod.
Prikazan je slučaj ženskog deteta rođenog u Ginekološko - akušerskoj Klinici u Kragujevcu sa klasičnom ekstrofijom mokraćne bešike i epispadijom koje smo pratili do trećeg meseca života. Zahvaljujući timskom radu ginekolog - neonatolog - dečji hirurg - pedijatar može se obezbediti uspešan operativni ishod uz očekivane manje komplikacije. Najvažnije je da dete ima ocuvan psihomotorni razvoj i izvesnu mogućnost kvalitetnog života.
Reference
Surer I, Ferrer FA, Baker LA, Gearhart JP. Continent urinary diversion and the exstrophy epispadias complex. J Urol 2003; 169: 1102-1105.
Developmental Abnormalities by System Australian Statistics 1981-1992. http://embryology.med.unsw.edu.au/Notes/urogen2.htm
http://www.emedicine.com/ped/Exstrophy and Epispadias Elizabeth B Yerkes, MD, Assistant Professor of Urology, Northwestern University Feinberg School of Medicine; Attending Urologist, Division of Urology, Children's Memorial Hospital of Chicago, May 18, 2006.
Oxford Journals MedicineHuman ReproductionVolume 17, Number 8 Pp. 2089-2095
Swedish Information Center for Rare Diseases, Smågrupps Centrum, the, Professor Ulla Sillén, The Queen Silvia Children's Hospital, Sweden.. Swedish National Board of Health and Welfare, The Swedish Information Center for Rare Diseases Date of publication: 2007-05-31 Version: 1.0
Novakov-Mikić A.,Miković Ž.,Ljubić A., FETALNE ANOMALIJE Ultrazvučna dijagnostika, paćenje trudnoće i prognoza, Ministarstvo zdravlja Republike Srbije 2007:151-153.
Ivan R Nikolić et al: Embriologija čoveka ;Tekst i atlas,2.izdanje, Beograd Novi Sad 2006;120-130.
KV SK, Mammen A, Varma KK. Pathogenesis of bladder exstrophy: A new hypothesis. J Pediatr Urol. 2015; 11(6): 314-8.
Monozygotic twins discordant for exstrophy of the urinary bladder, M Bugge J Med Genet. 1981 April; 18(2): 139–141.
H:Exstrophy of the Bladder and Epispadias - Lucile Packard Children's Hospital.mht
http://www.espu.org/European Society for Paediatric Urology
Deirdre O’Reilly, M.D., M.P.H., Neonatologist, Division of Newborn Medicine, Children’s Hospital Boston and Instructor in Pediatrics, Harvard Medical School, Boston, Massachusetts.
Rösch WH, Promm M. Bladder exstrophy : Quality of primary care and long-term
Stein R, Wessel L, Michel MS. Bladder augmentation and urinary diversion in children and adolescents. Urologe A. 2016; 55(1): 44-52.
Borer JG. Experience, Expertise and Dedication are Requirements for Successful Outcome in Bladder Exstrophy Care. J Urol. 2016; 195(1): 15.
Valerio E, Vanzo V, Zaramella P, Salvadori S, Castagnetti M, Baraldi E. Exstrophy-Epispadias Complex in a Newborn: Case Report and Review of the Literature. AJP Rep. 2015; 5(2): e183-7.
Canning DA. Re: Emotional and Behavioral Functioning in Children with Bladder
Inouye BM, Di Carlo HN, Young EE, Tourchi A, Gearhart JP. Secondary reclosure in classic bladder exstrophy: challenges and outcomes. Urology. 2015; 85(5): 1179-82.