The bladder exstrophy-epispadias complex is a rare, severe congenital birth defect where the bladder does not form closed inside the body. Instead, the bladder and urethra are split open and exposed on the lower abdomen, accompanied by separated pelvic bones and malformed genitals.
This complex developmental anomaly is caused by:
The condition is obvious at birth:
The first stage of surgery—bladder template closure—is ideally performed within the first 48 to 72 hours of life when the baby's pelvic bones are still flexible and can be closed without requiring bone cutting (osteotomy). Delayed closure makes the repair more difficult and increases the risk of bladder infection and template scarring.
Dr. Chowdhary is one of the few pediatric urologists in India experienced in managing this complex condition. He utilizes both **Modern Staged Reconstruction (MSER)** and **Complete Primary Repair (CPRE)**. The staged path includes neonatal closure, epispadias repair at 1-2 years, and bladder neck reconstruction at 4-5 years when the bladder has grown. For children with small bladder capacity, advanced continent urinary diversion (Mitrofanoff) is offered.
Mobilizing and closing the exposed bladder template and abdominal wall, often combined with pelvic bone approximation.
Reconstructing the split urethra and penis (or clitoris/labia) to achieve normal function and appearance.
Surgically tightening the bladder outlet at age 4-5 to allow the child to hold urine and achieve dryness.
Performed in the first days of life, closing the bladder and abdominal wall. A pelvic osteotomy is done if closure is delayed.
Performed at 12-18 months. The open dorsal urethra is tubulized, and the genitalia are cosmetically corrected.
At age 4-5, bladder neck reconstruction is performed. The child is enrolled in biofeedback and bladder training programs.
"Bladder exstrophy is a scary diagnosis, but Dr. Sujit Chowdhary is one of the few surgeons who has mastered its reconstruction. Our son's bladder template is rebuilt, and he is doing wonderfully."
"We traveled to Delhi for our son's epispadias repair. Dr. Sujit's surgical precision achieved excellent cosmetic and functional results. Truly grateful."
"The dedication Dr. Chowdhary shows to exstrophy patients is incredible. His step-by-step reconstruction plan gave our child a normal life."
"The nursing staff and Dr. Sujit are a fantastic team. They handled our infant's surgery with so much care and warmth."
"We traveled from another city just for Dr. Chowdhary. His approach is very scientific and caring."
Bladder exstrophy and epispadias are highly complex anomalies. Highly specialized staged reconstruction is crucial to restore form and function.
It is a severe congenital malformation where the bladder is malformed and exposed on the lower abdominal wall.
Primary closure is ideally performed within the first 72 hours of life, often in combination with pelvic osteotomy.
Epispadias is a malformation where the urethra opens on the top (dorsal) aspect of the penis rather than the tip.
Continence is achieved through staged reconstructions, bladder neck repair, or bladder augmentation combined with clean intermittent catheterization.
It is a surgical procedure to shape the pelvic bones closer together, which supports the bladder closure and improves long-term continence.
Yes, with specialized care and timely surgical reconstruction, the kidneys can be successfully protected for life.
Children require long-term follow-up with a pediatric urologist to monitor kidney health, bladder growth, and sexual development.
Staged functional reconstruction helps children with bladder exstrophy achieve continence. Schedule a consultation today.
D6, Club, 2, opposite Vasant Vihar, Vasant Vihar, New Delhi, Delhi 110057
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