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The nursing assessment of the genitourinary (GU) system involves a systematic inspection and palpation to identify abnormalities in the kidneys, bladder, and surrounding structures.InspectionMouth: Inspect for signs of kidney dysfunction, such as stomatitis (inflammation of the mouth) and ammonia breath, which may occur in advanced kidney disease due to the buildup of urea, breaking down into ammonia.Skin: Check for pallor, which could indicate anemia caused by kidney disease. Look for...
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The formation of dilute urine is a critical renal adaptation that maintains fluid balance, particularly during periods of high fluid intake. This process primarily involves the juxtamedullary nephrons. By adjusting the permeability of water and ions in response to physiological conditions, the kidneys can either conserve or excrete water, resulting in concentrated or dilute urine.
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The urinary bladder is a hollow, muscular sac that temporarily stores urine before it is expelled from the body. It can hold approximately 600 mL of urine prior to micturition. The bladder is retroperitoneal and located behind the pubic symphysis in the pelvic floor.
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The pathophysiology of urinary tract infections (UTIs) encompasses several progressive stages, beginning with bacterial colonization and culminating in potential systemic complications if untreated. UTIs are primarily initiated by bacteria, such as Escherichia coli, which often originate from the gastrointestinal tract and migrate to the urinary system through the periurethral area. This migration can occur via several routes, including improper hygiene practices, sexual activity, or...
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The lower urinary system consists of the urinary bladder and urethra, which are essential in storing and expelling urine from the body. Together with the internal and external sphincters, these structures work together to regulate urination effectively.Anatomy of the BladderThe urinary bladder is a muscular, stretchable organ behind the pubic bone and in front of the rectum. In females, the bladder is positioned anterior to the vagina and inferior to the uterus, while in males, it is located...
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Connatal Urinary Ascites in a Female Preterm.

Barbara Brunner1, Elisabeth Ralser1, Elisabeth D'Costa2

  • 1Department of Paediatrics II, Medical University of Innsbruck, Innsbruck, Austria.

Case Reports in Pediatrics
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Summary

This study presents a rare case of fetal bladder rupture and congenital urinary ascites in a female infant, linked to maternal pneumonia. Blue dye successfully identified the bladder leak, offering a safe diagnostic alternative for preterm neonates.

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Area of Science:

  • Neonatalogy
  • Fetal Medicine
  • Pediatric Surgery

Background:

  • Congenital urinary ascites is a rare condition in female infants, typically associated with bladder rupture and often presenting with other malformations.
  • Maternal health complications during pregnancy, such as viral pneumonia requiring intensive care, can impact fetal development and lead to rare conditions.

Observation:

  • A very preterm female infant developed significant isolated ascites, diagnosed via serial fetal ultrasound revealing megacystis.
  • Postnatal drainage confirmed the ascites was of urinary origin.
  • A bladder leak was visualized using instilled blue dye, which appeared in the ascitic fluid via a Foley catheter.

Findings:

  • The case demonstrates fetal bladder rupture leading to congenital urinary ascites in a female neonate, with a suspected link to maternal pneumonia and intensive care.
  • The infant experienced spontaneous micturition post-catheter removal, and a micturating cystourethrogram confirmed spontaneous closure of the bladder leak.
  • Instillation of blue dye proved to be an effective, non-radiographic method for diagnosing the bladder leak.

Implications:

  • This case highlights the importance of considering maternal health factors in the etiology of fetal anomalies.
  • The use of blue dye offers a valuable, safe, and accessible diagnostic tool for urinary leaks in preterm neonates, avoiding the need for contrast radiography.
  • Early diagnosis and management of congenital urinary ascites can lead to favorable outcomes, even in preterm infants.