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Pregnancy after repaired bladder exstrophy: a case report.

Dineli Kalansuriya¹, Jay Roberts², Sumudu Britton³

¹Department of Obstetrics and Gynaecology, Cairns Hospital, Queensland, Australia.

Case Reports in Women'S Health

|July 30, 2025

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Pregnancy after bladder exstrophy (BE) repair is high-risk. This case highlights successful management of a complex pregnancy in a patient with repaired BE and an extreme bicornuate uterus, achieving a term delivery.

Area of Science:

Reproductive Medicine
Urology
Congenital Anomalies

Background:

Bladder exstrophy (BE) is a rare congenital anomaly requiring surgical repair in childhood.
Pregnancy in individuals with repaired BE presents significant risks, including decreased fertility, miscarriage, preterm birth, and postpartum complications.
An extreme bicornuate uterus adds further complexity to pregnancy management.

Observation:

A 27-year-old primigravida with a history of repaired bladder exstrophy and an extreme bicornuate uterus presented for pregnancy management.
The patient experienced cervical shortening, recurrent antibiotic-resistant urinary tract infections (UTIs), pelvic girdle pain, and postpartum urinary incontinence.
This high-risk pregnancy necessitated management by a large multidisciplinary team.

Findings:

Keywords:

Bladder exstrophy Female urogenital diseases High-risk Obstetrics Pregnancy Pregnancy complications Urology

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Despite the complex medical history and complications, the pregnancy was successfully managed.
The patient achieved a term pregnancy.
Delivery was accomplished via an elective, individualized cesarean section.

Implications:

This case underscores the importance of multidisciplinary care in managing high-risk pregnancies in patients with repaired bladder exstrophy.
Successful term delivery is achievable even with significant anatomical challenges and complications.
Further research into optimizing pregnancy outcomes for this patient population is warranted.