Extracorporeal Shock Wave Lithotripsy | Exstrophy Epispadias

Extracorporeal Shock Wave Lithotripsy

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About Dr.Sujit

Dr. Sujit Chowdhary is a leading Pediatric Urologist in Delhi-NCR. He currently serves as the Senior Consultant for Pediatric Urology and Pediatric Neurosurgery at the prestigious Indraprastha Apollo Hospital, Delhi since 2005. Dr. Sujit has professional experience of over 25 years in the field of Pediatric Urology with absolutely zero complaints.

Extracorporeal shock wave lithotripsy

What is Exstrophy epispadias?

This is an ailment that afflicts the fetus’s bladder. And such an event happens merely after 4-5 weeks of conception. A bladder exstrophy epispadias is a developmental abnormality in the fetus where the bladder grows outside the body. As the name suggests, in exstrophy, a fetus’s bladder rear walls are positioned outwards rather than inwards.

This condition has a lasting impact making it difficult to have proper urine storage and bladder functions.

What is the cause of Exstrophy epispadias?

We have not been able to determine the facts that cause this ailment but it may be due to:
  • Genetic Factors- The presence of master control gene ISL, a gene responsible for bladder exstrophy.
  • Environmental Factors- The age of the mother becomes relevant.
  • Family History- It is relevant only if a parent suffers from Exstrophy epispadias
  • Then the firstborn child has a 50% chance of having it too.
  • The fertility treatment.

Diagnosis and Treatment

How do I diagnose the Exstrophy epispadias in my baby?

We perform a series of diagnostic tests to confirm Exstrophy epispadias in infant-like:
  • Physical examination- In a physical examination, the specialist studies the abnormal appearance of the genital organs of the newborn baby. It is done a few hours after the birth itself.
  • X-Ray- If there is any abnormality present than specialists recommend an X-ray to check the status of the internal urinary tract systems. The specialist looks for signs like umbilical cord low on the abdomen, separation of the pubic and pelvic bone and smaller genitals.
  • In prenatal diagnosis, the pediatric urologist does the high-resolution fetal ultrasound test and ultrafast Fetal MRI. These show the image of the fetus’s organs.

Exstrophy epispadias

Once an infant is diagnosed with Exstrophy epispadias the surgery is the option for a permanent cure. We use the reconstructive surgical technique to heal exstrophy epispadias in newborn boys and girls. The type of surgery is dependent on the severity of the condition.

  • Complete primary repair of bladder exstrophy- It is a single step surgery done on a three-month-old baby, involving the complete repair of the bladder and genital organs. Here, the pediatric urologist surgeon closes the bladder, abdomen and repairs the urethra and infant’s genitals. If it’s done on a newborn this also includes repairing pelvic bones.
  • Modern stages repair of bladder exstrophy- This surgery is for infants who are between 6- 12 months. There are three stages in this operation. First 72 hours after birth, the second one at the age of 6-12 months and last at age of 4-5 years. The first surgery is critical as it closes the bladder and abdomen. When the child is 2-3 years old, the pediatric surgeon does the bladder neck reconstruction surgery.
  • Mitchell technique- This is a new surgical technique for penis reconstruction. The penis is taken apart and assembled in normal shape. It also corrects the dorsee bend condition of the penis.


1. Will this surgery work for every kid?

2. What is the best time for surgical treatment?

3. Is extracorporeal shock wave lithotripsy painful?

4. What are the side effects of lithotripsy?

5. What size kidney stones require extracorporeal shock wave lithotripsy?

6. How is extracorporeal shock wave lithotripsy performed?

7. Is shock wave painful?

8. How long does it take to recover from lithotripsy?

9. How would you feel after lithotripsy?


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