Valgus bladder is a rare congenital malformation that occurs in 1 in every 35,000-40,000 fetuses. When the baby is born, the bladder is turned outward to the outside of the stomach, and the bladder has not closed and has been leaking out. Because the treatment cycle of this deformity is as long as 5 years, the cost is expensive, up to more than 200,000 yuan, so many children are discarded by their parents as soon as they are born.
Recently, Liu Guochang, director of the Department of Urology of Guangzhou Women and Children's Medical Center, introduced the advanced kelly technique for the first time in South China, treated a baby girl with bladder valgus in Maoming, and completed all corrective surgeries at one time, and the cost of surgery dropped to 50,000-60,000, only 1/3 or 1/4 of the previous one.
Prenatal diagnosis also makes it difficult to detect this deformity
Liu Guochang introduced that bladder valgus is one of the most complex congenital malformations of the urinary system in children, and only a few children's hospitals in the country can carry out surgical treatment. This deformity is caused by abnormal embryonic development, and once the child is born, the bladder does not close and opens up in the middle of the lower abdomen.
The surrounding tissues that are attached to it are also often deformed and abnormal, such as malformations of the abdominal wall, bladder, external genitalia, pelvic bones, rectum, and anus, and the external genitalia are also deformed because the urethra is closely connected to the cavernosum of the penis or the vagina.
Even more difficult is that prenatal diagnosis is difficult to definitively diagnose this deformity. "In the early embryonic stage, because of immature development, it is impossible to detect this disease by means such as b ultrasound. By the middle and late stages of the embryo, when umbilical bulging or fissure is shown by ultrasound, and there is a high suspicion of bladder valgus, it is no longer recommended or impossible to terminate the pregnancy. Liu Guochang said.
Traditional treatment requires multiple surgeries for up to 5 years
Liu Guochang introduced that after the birth of a child with valgus bladder, it is best to undergo surgery immediately. If the surgery is performed within 72 hours, there will be no need to open the pelvic osteotomy, as the baby's bones have not yet been formed.
Traditional surgical treatment is carried out in three stages: closure of the child's abdominal wall, bladder and posterior urethra in the neonatal period, pelvic osteotomy and external fixation of the pelvis using an external fixator if treated after 72 hours; repair of urethral fissures from 6 months to 1 year of age; bladder reconstruction, urinary control recovery, and vulvar plastic surgery at the age of 3 to 5 years.
This treatment process cycle is as long as 5 years, the cost is as high as 150,000 or even more than 200,000, and there are many complications, the degree of psychological damage to the child is large, and it may leave a shadow on the child's psychology. But if left untreated, most children will survive childhood due to serious complications.
Many children go untreated or even abandoned
Liu Guochang said that many families of children with valgus bladder will mostly choose to abandon their newborn children after hearing such a surgical statement from doctors, who are scattered in welfare homes everywhere. Although the incidence of this deformity is low, multiplied by China's huge population base, it is always possible to find bladder ectropion in welfare homes every year.
Guangzhou Women and Children's Central Hospital is one of the few hospitals in China that can treat this disease, and the children who have recently been treated are all paid for by welfare homes, and the best treatment period has been missed when they are sent for treatment.
Liu Guochang also personally saw a bladder ectropion on the side of the road selling newspapers. "Fortunately, his parents did not abandon him, but unfortunately they can only rely on the meager income from selling newspapers to treat the disease, and they can only go to the hospital to deal with complications such as inflammation at a time, and there is no money for surgery, but this is already a good treatment in the case of bladder ectropion."
For the first time in South China, the kelly technique was successfully introduced
For many years, Liu Guochang has been looking for surgical methods that can alleviate the pain of the child and reduce the burden on the child's family. Among them, he has been paying attention to Professor Kelly's self-created kelly technique in 1995 at the Royal Children's Hospital in Melbourne, Australia.
This surgical procedure can complete the entire surgical reconstruction and correction process at one time by completely releasing the soft tissues and muscles of the basin, completely separating the cavernosum of the penis (clitoris) and its vascular nerve bundles, and reconstructing the urethra, urinary control and vulvar plasty.
Last month, Liu Guochang also made a special trip to Shanghai to observe the surgery performed by Professor Kelly himself. On May 21, Liu Guochang's team successfully used the kelly technique to treat a baby girl with bladder valgus from Maoming in March, marking the successful completion of the first kelly treatment of a child in South China.
This new procedure takes only 5 to 10 hours, a hospital stay of only 10 to 20 days, and a cost of only 50,000 to 60,000. After surgery, children can obtain reproductive functions normally, and there is basically no major impact on life. "In the future, the surgical treatment of bladder valgus is no longer a big problem, and when we face the family, we can finally breathe a sigh of relief and introduce our kelly technique with a straight face." Liu Guochang sighed. He hopes that the bladder ectropion will not be discarded by their parents because of the cost of treatment.
[Reporter] Li Xiuting Intern Chen Jinyuan
[Correspondent] Easy to be sensitive
[Proofreading] Lan Shuru
【Author】 Li Xiuting
【Source】