Extracorporeal Shock Wave Lithotripsy | Exstrophy Epispadias

Extracorporeal Shock Wave Lithotripsy

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ড. সুজিত এর সম্পর্কিত

ডাঃ সুজিত চৌধুরী দিল্লি-এনসিআরের একজন শীর্ষস্থানীয় পেডিয়াট্রিক ইউরোলজিস্ট। তিনি বর্তমানে 2005 সাল থেকে দিল্লির মর্যাদাপূর্ণ ইন্দ্রপ্রস্থ অ্যাপোলো হাসপাতালে পেডিয়াট্রিক ইউরোলজি এবং পেডিয়াট্রিক নিউরোসার্জারির সিনিয়র পরামর্শদাতা হিসাবে দায়িত্ব পালন করছেন। ডাঃ সুজিতের পেডিয়াট্রিক ইউরোলজির ক্ষেত্রে 25 বছরেরও বেশি সময় ধরে পেশাদার অভিজ্ঞতা রয়েছে যার একেবারে শূন্য অভিযোগ রয়েছে।

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.

রোগ নির্ণয় এবং চিকিত্সা

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.
এক্সট্রফি এপিস্পাডিয়াস

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.

প্রায়শই জিজ্ঞাসিত প্রশ্নাবলী

1. Will this surgery work for every kid?
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2. What is the best time for surgical treatment?
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3. Is extracorporeal shock wave lithotripsy painful?
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4. What are the side effects of lithotripsy?
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5. What size kidney stones require extracorporeal shock wave lithotripsy?
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6. How is extracorporeal shock wave lithotripsy performed?
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7. Is shock wave painful?
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8. How long does it take to recover from lithotripsy?
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9. How would you feel after lithotripsy?
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প্রশংসাপত্র

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