Paediatric surgery: bladder exstrophy: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Paediatric surgery: bladder exstrophy

Sample item

A newborn has an exposed bladder mucosa on the lower abdominal wall with a widened pubic symphysis and epispadias. What is the management principle?

AImmediate cystectomy and ileal conduitBLeave it open until age 10CObservationDCover the bladder and perform staged surgical closure with reconstruction of the bladder neck and genitalia

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Cover the bladder and perform staged surgical closure with reconstruction of the bladder neck and genitalia

Bladder exstrophy is a failure of closure of the lower abdominal wall with pubic diastasis and epispadias. Management involves covering the bladder with plastic film, early closure of bladder and abdominal wall (often within 72 hours) with pelvic osteotomy if needed, then epispadias repair and bladder neck reconstruction in stages.

Option by option

A. Immediate cystectomy and ileal conduit
Cystectomy is not primary treatment.
B. Leave it open until age 10
Prolonged exposure causes metaplasia and infection.
C. Observation
Untreated exstrophy is incompatible with normal function.
D. Cover the bladder and perform staged surgical closure with reconstruction of the bladder neck and genitalia (correct)
Correct. Staged reconstruction is the standard.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Cover the bladder and perform staged surgical closure with reconstruction of the bladder neck and genitalia. Bladder exstrophy is a failure of closure of the lower abdominal wall with pubic diastasis and epispadias.

Why is "Immediate cystectomy and ileal conduit" not the answer?

Cystectomy is not primary treatment.

Why is "Leave it open until age 10" not the answer?

Prolonged exposure causes metaplasia and infection.

Why is "Observation" not the answer?

Untreated exstrophy is incompatible with normal function.

What concept does this question test?

It tests Paediatric surgery: bladder exstrophy in General Surgery. Management involves covering the bladder with plastic film, early closure of bladder and abdominal wall (often within 72 hours) with pelvic osteotomy if needed, then epispadias repair and bladder neck reconstruction in stages.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric surgery: bladder exstrophy?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.