Monday, January 23, 2023

Is Bladder Exstrophy A Disability

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Symptoms Diagnosis And Treatment Of Urinary Tract Cancers

Disney Extravaganza – AGC to ORL – Nov 3 2017 – Jamie’s Dream Team

There are several symptoms associated with bladder cancer and kidney cancer, such as: tiredness, unexplained weight loss, increased frequency of urination, pain during urination, pain in your abdomen or side, a lump in your side, and finding blood in your urine.

Your doctor may use several techniques to discover whether you have cancer. She may use a physical examination, a CT scan, an MRI, a cell biopsy , urine lab tests, and/or a cystoscopy .

Treatment for bladder cancer could include surgery, chemotherapy, and the use of drugs for targeted therapy.

What Is Renal Agenesis And How Is It Treated

There are two kinds of renal agenesis:

  • Unilateral renal agenesis. This is when a baby is born with just one kidney instead of two. Most babies with this condition grow and develop normally. However, some have other urinary tract defects that may cause problems for the one kidney. Health care providers can use ultrasound and other tests to check for problems that need special care. Between 1 in 450 and 1 in 1,000 babies is born with this condition.
  • Bilateral renal agenesis. This is when a baby is born without kidneys. Babies with this condition often die in the first days of life. To help a baby be healthier when he is born, health care providers may use treatments during pregnancy, like serial amnio infusion, to try to help the babys lungs develop before birth. These treatments are very specialized and are still being researched. Talk to your provider to find out if these treatments may help your baby. After birth, the baby needs dialysis. About 1 in 3,000 babies is born with this condition.
  • What Are The Symptoms Of Bladder Exstrophy

    The main symptom of bladder exstrophy is the bladder protruding through an opening in the belly. Bladder exstrophy can lead to other symptoms, including:

    In some cases, babies may also have inguinal or umbilical hernias. Hernias occur when part of the stomach lining bulges out of the abdominal wall. Hernias often need surgery to put organs in the correct place.

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    Deterrence And Patient Education

    The most important factor in the quality of life of patients with exstrophy bladder is the degree of urinary continence. Those who attain a sufficient bladder size with age can hold urine for 2 to 3 hours during the day and remain dry during the night as well. However, a considerable proportion of children may not be able to do so due to poor bladder growth. This may lead to psychosocial issues, school dropouts, delays in the education of these children, etc. Also, parental issues, including work leaves, have also been highlighted in the literature. Engaging the child in a voiding program, educating about the benefits of clean intermittent catheterization , training him/her regarding the procedure of self-CIC, ensuring proper hygiene, ensuring compliance of the medications, etc. are crucial steps that must be reinforced to the parents periodically.

    How Is Pediatric Bladder Exstrophy Diagnosed

    What Is Bladder Exstrophy?

    A babys bladder develops in the first trimester of pregnancy, and bladder exstrophy is usually diagnosed during an ultrasound before the child is born. If the condition is not diagnosed before delivery, it is obvious at birth.

    In either case, treatments typically begin very shortly after delivery. Bladder exstrophy is diagnosed when any one of several abnormal conditions exist in a childs bladder, urinary tract, or abdominal area.

    A variety of imaging tests are used to determine the extent of the condition. Your doctor may also conduct urine tests and bladder function tests to check for infections and to determine whether the kidneys are functioning properly.

    Children with bladder exstrophy could also have widened pelvic bones or other abnormalities in the abdominal region, such as an off-center belly button. Unusual bladder formation associated with bladder exstrophy sometimes includes a misshapen bladder, a short bladder neck, a short urethra in boys or a wide labia or very narrow vaginal opening in girls.

    Such related conditions are usually addressed during the surgeries required to reverse bladder exstrophy.

    Following treatment, most children with this condition are able to have normal elimination and sexual activity.

    Recommended Reading: How To Train An Overactive Bladder

    What Problems Can Genital And Urinary Tract Defects Cause

    Genital and urinary tract defects affect one or more of a babys body parts, including:

    • Kidneys, the pair of organs that remove waste from the blood and make urine
    • Bladder, the organ that holds urine
    • Ureters, two tubes that carry urine from the kidneys to the bladder
    • Urethra, the tube that carries urine out of the body from the bladder

    Genital and urinary tract defects can cause:

    • Urinary tract infections . These are infections in any part of the urinary tract. A UTI causes a burning feeling when you urinate .
    • Kidney failure. This is a serious condition that happens when the kidneys dont work well and allow waste to build up in the body.

    How Is Bladder Exstrophy Treated

    Babies born with bladder exstrophy need surgery to correct the condition.

    Sometimes, babies have one surgery to close the abdomen and repair the urethra. Or babies may have surgery in three stages:

  • Immediately after birth, babies have an operation to close the pelvis and bladder.
  • Around 6 months of age, babies have another operation to rebuild the sex organs and urethra.
  • Around 4 to 5 years of age, or at potty training age, surgeons fix the bladder so that it can hold urine until its time to expel it.
  • The type and number of surgeries your baby needs depend on how severe their symptoms are. Your babys surgeon will explain the best approach for your babys needs. Some children may need additional surgeries to achieve continence as they grow.

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    Covenant Transport Sued By Eeoc For Disability Discrimination

    Trucking Company Refused to Hire Applicant Because of His Disability, Federal Agency Charges

    CHATTANOOGA, Tenn. — Covenant Transport, Inc., a trucking company headquartered in Chattanooga, Tenn., violated federal law by refusing to hire an applicant because of his disability, the U.S. Equal Employment Opportunity Commission charged in a lawsuit filed yesterday.

    According to EEOC’s lawsuit, the applicant applied for employment as a commercial driver. Covenant conditionally approved his application pending a license check and drug screening. The applicant told Covenant’s representative he was unable to provide a urine sample due to a medical condition, bladder exstrophy, but could provide blood for the drug screening. Exstrophy of the bladder is a congenital absence of a portion of the abdominal wall and bladder wall.

    Covenant initially agreed to the blood screening and later decided not to hire the applicant because of his medical condition and the fact that he could not provide a valid urine specimen. Covenant withdrew the offer of conditional employment. EEOC’s suit also claims the company knew the applicant could not provide a valid urine specimen due to his medical condition and refused to provide him the opportunity to undergo drug screening because of his disability.

    “EEOC remains as committed as ever to enforcing the ADA to remove barriers to employment for persons with disabilities,” said Katharine W. Kores, district director for the Memphis District Office.

    Bladder And Abdominal Wall Repair Operation First Few Days After Birth

    This operation closes the bladder and abdominal wall, so that the bladder is inside the body and in the correct position. After the operation, urine will drain from the bladder through a number of catheters placed in the bladder.

    The child will come back to the ward to recover. For the first day or so, they will have an intravenous infusion giving fluids and medications until the bladder starts to recover. The child will need to have regular pain relief after the operation. Initially, pain relief will be given through an epidural.

    They may also have ureteric stents in place, which are thin tubes inserted through the abdomen into the childs bladder and up each ureter. These drain away urine while the bladder recovers from surgery. A urethral stent will also have been inserted into the urethra to keep it open while the area heals.

    After the first week, some of the tubes will be removed. The drip will be removed when the child starts feeding again. The epidural is usually removed three to five days after the operation. Seven days after the operation, the nurses will remove the ureteric stents if they were inserted. This will be done on the ward we will give the child pain relief beforehand, although it may still be uncomfortable.

    The child will be able to go home once they are recovering and have been reviewed by the doctors. Around three months later, the child will have a cystoscopy to check how the bladder is healing.

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    What Causes Bladder Exstrophy

    Experts dont know why bladder exstrophy occurs. There is some evidence that environmental factors and genetics play a role.

    Risk factors for bladder exstrophy include:

    • Family history: Adults who had bladder exstrophy as children have about a 1 in 70 chance of having a child with the condition. The risk is higher if parents have another child with bladder exstrophy.
    • Race: Bladder exstrophy is most common in white families.
    • Sex: Males are up to three times as likely as females to have bladder exstrophy.
    • Fertility treatments: Using assisted reproductive technology such as in vitro fertilization can increase the risk of bladder exstrophy. Some studies have shown that parents who undergo fertility treatments are about seven times more likely to have a child with bladder exstrophy.

    How Are Bladder Exstrophy And Epispadias Diagnosed

    Bladder exstrophy is sometimes diagnosed before birth using ultrasound scans. However, it is often not picked up before birth, but will be obvious once your baby is born. Epispadias in boys is usually identified at birth, but in girls the diagnosis is usually made later when they develop bladder control problems or infections.

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    What To Expect From Your Doctor

    Your doctor is likely to ask you a number of questions, such as:

    • Have you ever had a child with bladder exstrophy or other birth defects?
    • Has anyone in your family been born with bladder exstrophy?
    • If necessary, are you able to travel to a facility that offers specialized care?

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    Will Bladder Exstrophy Be A Lifelong Disability

    In simple terms, a Mitrofanoff procedure:

    The long-term outlook for children born with bladder exstrophy is very good. In the majority of cases, when pediatric urologists and surgeons familiar with the condition and related complications follow a bladder reconstruction and treatment plan, affected children establish normal bladder function and have no lifestyle restrictions. Also, this rare birth defect seems to have no affect on life expectancy.

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    Bladder Exstrophy Treatment Options

    Each child with bladder exstrophy is different. Your childs care and treatment will depend on their needs. You and your childs urologist will develop a plan of care just for your child.

    We work with your family to assess your childs needs and plan the steps and timing of their care.

    Our surgeons are experienced treating children who:

    • Need surgery within the first few weeks of life
    • Are diagnosed later in childhood
    • Had the repair done at another hospital and need more surgery or other treatment

    For young babies, we do all these steps in a single surgery , 3 to 4 months after birth. An orthopedic surgeon closes the pubic bones, and a urologist completes the other steps.

    Doing everything at once is more complex than surgery in stages over several years. But 1-stage repair means your child will have better outcomes. The bladder is more likely to grow to normal or nearly normal size, giving your child more control over urine flow. Even so, 50% to 60% of children will need more surgery later in childhood. Your child may need surgery to help improve bladder control or stop backflow of urine from the bladder to the kidneys .

  • Care right after surgery

    Your baby will be in the hospital for 7 to 10 days when they have surgery. They will have:

  • Intravenous line . Your baby will have a tube inserted into a vein to give fluids and antibiotics for several days.
  • Heart and breathing monitor. Your babys heart rate, breathing and oxygen levels may be measured for several days.
  • What Are Genital And Urinary Tract Defects

    Genital and urinary tract defects are birth defects. Birth defects are structural changes present at birth that can affect almost any part of the body. They may affect how the body looks, works or both. Birth defects can cause problems in overall health, how the body develops or how the body works. About 1 in 500 babies is born with genital and urinary tract defects.

    Babies with genital and urinary tract defects often live healthy lives. Your baby may only need regular visits with his health care provider.

    Also Check: Losing Control Of Your Bladder

    Special Voiding Improvement Program For The Exstrophy

    Children with bladder exstrophy face a combination of medical and emotional challenges as they work with their urology team. Developing a continence management program is an ongoing process that is often stressful for children and their families. The voiding improvement program provides hands-on one-on-one assistance to the child and family before and after bladder neck repair.

    The clinic is staffed by a specially trained, multidisciplinary team including a pediatric urologist, pediatric nurse practitioner, pediatric behavioral psychologist, and pediatric clinical nurse.

    The Voiding Improvement Team also assists the pediatric urologist in the evaluation of readiness for bladder neck reconstruction to help the child and family prepare for the post-surgical work that will allow for favorable continence outcome.

    After bladder neck reconstruction surgery we work with children and families using both behavior modification and muscle retraining procedures to teach the child, family, and the child’s bladder musculature to function at their maximum potential for long-term continence.

    After bladder neck surgery, frequent daily phone consultations occur until the child is voiding well and tube free.

    Visit usually last one hour and may include the following treatment components:

    • bladder ultrasound

    • biofeedback for bladder muscle retraining

    • establishment of a voiding urine

    • assessment of barrier to adherence

    • nutrition education

    What Is Bladder Exstrophy

    Bladder exstrophy is a birth defect where your bladder develops inside out. Your bladder is a small organ in the low abdomen . Shaped like a balloon, it holds urine until youre ready to go to the bathroom.

    In newborns with bladder exstrophy, the skin and pelvis do not join correctly. As a result, the bladder may not close. It sticks out of the skin on the babys belly. The bladder may also be flat instead of round.

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    How Does Bladder Exstrophy Affect The Body

    Bladder exstrophy affects a babys urinary system. Typically, when your bladder fills with urine, nerve signals tell your brain that your bladder is full. To urinate , your bladder contracts and forces urine through your urethra and out of your body.

    With bladder exstrophy, the cloaca doesnt develop as it should. The cloaca is the area where the reproductive, digestive and urinary organs come together. Babies with bladder exstrophy empty urine through the opening in the abdomen instead of through the urethra.

    Bladder Exstrophy At Seattle Childrens

    Seattle Childrens Urology Department is known worldwide for our research and skill in caring for children with this condtion and is named a Center of Excellence by the Association for the Bladder Exstrophy Community . Our goal is to help your child have good bladder control and bladder health.

    For more information, contact Urology at .

    If you would like an appointment, ask your childs primary care provider for a referral.

    • The experts you need are here
    • Surgeons, doctors and nurses who have experience with all aspects of bladder exstrophy will take care of your child.
    • We are the regions only referral center for patients born with bladder exstrophy. Our surgeons are experts at repairing this condition in babies. They also are skilled at procedures children may need later in childhood.
    • Based on the organs affected, your childs urologist may involve other specialists through our Reconstructive Pelvic Medicine Clinic. Your childs care team may include a gynecologist, gastroenterologist and orthopedic surgeon. Our team approach means your child gets coordinated care each step of the way from experts who know your childs full treatment plan.
    • We arrange your clinic visits so your child can see all the providers they need in one day, in one place, instead of having to make separate visits.
  • Care from prenatal diagnosis to young adulthood
  • We also treat many older children, including children who have had surgery somewhere else. We provide second opinions, too.
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    Qualifying For Disability Benefits Based On A Limited Functional Capacity

    If you don’t qualify under a cancer listing because your cancer has not progressed as much as the above listings require, the SSA will assess your residual functional capacity . Your RFC is the most that you can do while working a regular 40-hour workweek. Generally, if you cannot sit for six hours in an eight-hour day and cannot stand or walk for long periods of time , then you will be found disabled. Depending on your age, you also can be found disabled if you can perform sedentary or light exertional level work. In addition, if you are markedly limited in your concentration, persistence, or pace, then you can be found disabled.

    The SSA will consider any combination of limitations you may have resulting from your bladder cancer or kidney cancer when establishing the level of work you can do. Having bladder cancer or kidney cancer can cause both physical and emotional limitations. Physically, you might be unable to stand for long periods based on symptoms of weakness or pain. You might also need to take frequent breaks, which could interfere with your ability to perform work. Mentally, you might have depressive symptoms, which can affect your ability to concentrate for sustained periods or to perform work tasks at a normal pace. In addition, the side effects of treatment for bladder cancer or kidney cancer normally include nausea, fatigue, and pain.

    You could be eligible for up to $3,148 per month in SSDI benefits

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