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Isolated bladder exstrophy in prenatal diagnosis

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Isolated classic bladder exstrophy (CBE) is the most common variant of the bladder-exstrophy–epispadias complex (BEEC). The BEEC represents a spectrum ranging from isolated epispadias over CBE to the most severe form, cloacal exstrophy. We report on a series of 12 cases with CBE diagnosed prenatally and illustrate the spectrum of prenatal ultrasound findings with comparison to prior published reports on this entity.

Methods

This was a retrospective study involving 12 fetuses with CBE at two large tertiary referral centers in Germany over a 14-year period (2004–2018).

Results

Median diagnosis was made with ultrasound in 24 + 5 (IQR25,75: 21 + 2, 29 + 0) weeks of gestation. All fetuses presented with the pathognomonic findings non-visualization of the fetal bladder and protruding abdominal mass below the umbilical cord insertion. All fetuses showed normal kidney anatomy and normal amniotic fluid throughout pregnancy. Epispadia was visible prenatally on ultrasound in 6/8 male fetuses. 1/12 Parents opted for termination of pregnancy, 11/12 fetuses were live born and received reconstructive surgery.

Conclusions

Isolated CBE is an extremely rare prenatal sonographic finding. Prenatal diagnostics should exclude additional malformations within the spectrum of cloacal malformations.

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Author information

Authors and Affiliations

  1. Department of Obstetrics and Prenatal Medicine, University of Bonn, Bonn, Germany

    Michael R. Mallmann, Annegret Geipel, Christoph Berg & Ulrich Gembruch

  2. Department of Obstetrics and Gynecology, University of Cologne, Cologne, Germany

    Michael R. Mallmann, Ingo Gottschalk & Christoph Berg

  3. Department of Pediatric Surgery and Pediatric Urology, Children’S Hospital of Cologne, Cologne, Germany

    Birte Mack-Detlefsen, Rebecca Pohle & Thomas M. Boemers

  4. Department of Neonatology and Pediatric Intensive Care, University of Bonn, Bonn, Germany

    Heiko Reutter

  5. Institute of Human Genetics, University of Bonn, Bonn, Germany

    Heiko Reutter

Authors
  1. Michael R. Mallmann
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  2. Birte Mack-Detlefsen
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  3. Heiko Reutter
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  4. Rebecca Pohle
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  7. Christoph Berg
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  8. Thomas M. Boemers
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  9. Ulrich Gembruch
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Contributions

MRM: project development, data collection, data analysis, manuscript writing. BM-D: data collection, data analysis. HR: data analysis, data analysis, manuscript writing. RP: data collection, manuscript editing. IG: data collection, data analysis, manuscript editing. AG: data collection, data analysis, manuscript editing. CB: data collection, data analysis, manuscript editing. TMB: project development, data collection, manuscript writing. UG: project development, data collection, data analysis, manuscript writing. All authors finally approved the manuscript.

Corresponding author

Correspondence to Michael R. Mallmann.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Mallmann, M.R., Mack-Detlefsen, B., Reutter, H. et al. Isolated bladder exstrophy in prenatal diagnosis. Arch Gynecol Obstet 300, 355–363 (2019). https://doi.org/10.1007/s00404-019-05193-x

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  • DOI: https://doi.org/10.1007/s00404-019-05193-x

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