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Bladder Exstrophy - DD waiting for Kelly Procedure - any experience?

20 replies

Starshinetiger · 26/03/2010 21:57

Hope I am posting this in the right topic... DD (1 last week) was born with bladder exstrophy and we are expecting her to have Kelly procedure at GOSH in the summer.

Just wondered if anyone on here has been through this and can give me some heads up what to expect.

Am a control freak and it will help me to prepare if I can hear about other's experiences GOSH have told us to expect her to be in for 1-2 weeks after op and then at home for 2 weeks with catheter in and then back in for 3 days, but I would really like some understanding of what pain levels to expect for her, etc.

Thanks!

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PositiveAttitude · 27/03/2010 09:37

Just seen this post. Am dashing out to take DD2 to work in a minute, but wanted to post and I will return later.

We adopted DD4 who had bladder exstophy. When she came to live with us her abdomen was open and ureter diverted into her bowel. (adopted from Russian orphanage,so very basic medical help given before we had her) She now has a mitroffanoff in situ, and had reconstructive surgery on abdomen. Not sure if I can be of any help to you. DD4 is now 12. She copes well with catheterising herself through a stoma.

I will peep back on later and see if I can help you in any way.

Hope she is well. Have you had any problems with kidney infections? Best of luck.

Starshinetiger · 27/03/2010 12:43

Hi Positive - thanks for that. I know we are very lucky indeed that DD was born to us in this country where she can get such great care. Is good to hear about your DD4's experience. We have been very lucky with DD so far - no utis, no kidney infections, just intolerances to several foods (which with my family history was to be expected anyway).

I'm not really familiar with exactly what all the different terms mean as we've just been told that she will have the Kelly Procedure later this year - to try and give her bladder control through creation of a muscle - and that worst case scenario, if that doesn't work, is that she will be have something fitted, which she just drains every now and then as regularly as one would go to the toilet.

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PositiveAttitude · 27/03/2010 15:58

Hi StarShine, I have tried to have a look at the Kelly procedure, but cant seem to get too much information. (I was a nurse, so am used to deciphering doctors speak, but just cant find much info on it.) I assume this is a newer treatment than our daughter has had. There was no question of her being able to have bladder control/muscle control as she had no bladder!!. So I suppose we went straight to the mitroffanoff, which is a bladder made out of part of her bowel, made into a pouch (bladder) It is attached to her ureters and then to her appendix, which has been brought out on to her abdomen. Every three hours she puts a tube into the stoma and the urine drains away. Quite simple really and she can NEVER wee herself.

It was a large operation when she was about 5 (we brought her into this country when she was 3). Does your DD have the pelvic problem too? Does she need to have oesteotomies? Our DD had that all done at the same time.DD is now a very happy 12 year old. I cant think of anything she doesnt do because of her "disability".

Can I be nosey? Did you kn ow that there was a problem before your DD was born? Or was it a terrible shock afer gi......

...... got to go.DS just kicked a football from the garden through into the kitchen and smahed a glass bottle of orange juice that needs clearing up!! Aren't children just lovely........

Starshinetiger · 29/03/2010 13:57

Hi Positive - thanks for sharing your experience and for trying to look up Kelly procedure. I think this has probably become practice since your DD had her procedure.

We did not know about DD's complications before she was born - apparently there is about a 50% chance of it being diagnosed in utero (sp?) in the UK. As I see it - I would have only spent 20 weeks worrying about it if I had known before she was born, the only thing we would have had more chance to prepare was for someone to look after our DS, but we were lucky enough that my Mum just dropped everything to be with him during the week and my PIL took over at weekends (they both work) to let her get home and get things sorted. Theoretically it should have been diagnosed at our 20 week scan as I was sent out to have a drink and then come back in again, so the sonographer could see the baby with a full bladder - something she evidently didn't see as there was no bladder to see full!! But hey, am quite philosophical about these things. Reminds me though - I did mean to write a letter to the hospital so they could use our case for training purposes

When she was born, noone at our local hospital knew what it was - they clingfilmed the area and took her up to SCBU and then my DH had to help the consultant work the digital camera so they could take photos to send to the bigger hospitals. Once they got onto GOSH they knew straight away what it was, so that was a relief. Mind you, I was planning a home water birth, but not only the first, but also the replacement pool we hired both had punctures, so I'm now well and truly a believer in fate, as we were obviously meant to be in hospital for her birth!

As I say, we are really lucky that DD was born in this country where GOSH have specialists in this condition. Also, although DD has bladder exstrophy, had a cyst on her bowel a malrotated bowel and her appendix is up under her left rib, really she has so far suffered very little complications from it (touch wood). At 1 day old she went for surgery where they removed the cyst, unrotated her bowel, formed a bladder from the plate that existed and a path for it to drain. They also brought her pelvic bones together and she was kept paralysed and sedated for 9 days afterwards to allow her optimum recovery. I'm also a firm believer that the fact that I managed to express for first 2.5 weeks for her tube feeding and then bf her for a year has not harmed her recovery, but then it doesn't really matter whether that actually helped, or just made me feel better

I do just think that there are many worse things that could have happened to her than this.

I don't know what osteotamies are? Maybe we have yet to learn. Luckily her pelvic bones do seem to be healing well (as far as we can tell without xray, etc so far) - she started crawling at 6.5 months (shock - DS didn't start 'til 9 months) and is taking her first proper steps now at 12.5 months, so seems to be doing okay on that front.

Have been told her reproductive organs are fine - Consultant actually said to DH - our expert who sees adult bladder exstrophies here says that they tend to be more fertile than average, so you need to have "the chat" early on with her - DH responded that she wasn't going out 'til she was 25 and the consultant said - "No, really, you do need to be very clear with her" - !!!!!

Anyway, am waffling, but is nice to hear from someone whose child has been through this and is doing well. Thanks!

OP posts:
PositiveAttitude · 29/03/2010 14:34

Great to hear you being so positive about it all. The Osteotomy is what your DD had done at 1 day old - the pelvis being brought together. Because our DD didn't have it done until she was 5, she does still walk a little "unusually".

Yes, our consultant also had the pregnancy warning. I need to have that talk soon with DD. She is nearly 13, but quite immature and no periods yet. I have always been open and have explained it in the past, but it does need re-iterating. [gulp]

I really hope your DD does well with her surgery in the summer.
Always here if you want to ask anything.

KMC78 · 27/05/2010 13:36

HI There! My little girl was born in 2008 very prematurely with BE so we're also still waiting for the Kelly to be done. I'm just going to call GOSH to see if they have any date yet?!
There is so much info out there but i would concentrate on talking to your consultant and the specialist nurse at GOSH. Every country and even every surgeon may do things slightly differently.
Would love to know how you're getting on so keep updating x

newworks · 21/06/2010 00:29

my child has BE and just had the mitrofanoff procedure. she is 7, wondering if anyone has dealt with the pain and fear of starting to cath through the new stoma

Starshinetiger · 12/08/2010 13:31

I just dropped off this thread as it was just PositiveAttitude and I talking for the first few posts.

KMC78 - sounds like a lot to cope with - BE and premature. Hope you got a response from GOSH about proposed surgery date. We still don't have a date, but after just waiting and waiting, we've just booked our first family holiday for beginning of October, so now I'm kind of hoping we don't get a date before November Grin

We did go in for a check-up at beginning of July and she's doing well, so I guess there's no rush... Just when they tell you at the beginning that they like to do the procedure between 1 and 2 and DD is now nearly 17 months, we start to get eager that it will happen in next few months.

Newworks - sorry can't offer anything with regard to mitrofanoff procedure - hope your DC is doing well now.

I'm guessing from all of you that you haven't had a subsequent child since your DC with BE? Am I mad to be thinking that we would like another child? I guess it seems daft to consider it when the odds of having another child with BE are so much greater?

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lots33 · 23/08/2010 10:33

Hi really interested to see this thread. I am 38 weeks pregnant with my first baby boy who was diagnosed at 23 weeks with BE. I am being induced next week and then baby will be transferred to GOS for operation .....don't know what to expect or how long we will be there for. It would be good to hear about other's experiences. I am also hoping to epress and then BF when DS is ready.

We have read stuff of the internet but I guess until he is born and we meet the doctors at GOS we will know very little.

Any news on both of your DD's Kelly's procedures? Also interested that everyone posting so far has DD's as BE is apparently much more common in boys.

M0lli · 09/09/2010 08:24

Hi, I'm also very interested seeing this thread. I had twin baby boys 3 weeks ago and one was born with bladder exstrophy (not picked up on the scans). We were immediately transferred to GOSH who performed bladder closure op when he was 3 days old. Our son is recovering really well from op but the whole thing has been a complete rollercoaster of emotions...joy at the birth of our boys but I've been so worried at the thought of my tiny boy being in pain. Anyway we are now home andlife is getting some normality back. We've been told my son will need Kelly op between 18 months and 2 years. Would be great to hear anyones experiences of the Kelly op as don't really know what to expect.

KMC78 · 15/10/2010 14:40

Hi MOlli,

Congratulations on the birth of your twins - i've no idea how you have coped up to now! We're still waiting for a date for my daughter's Kelly procedure so i'm not really able to tell you too much about that i'm afraid.
Karen Ryan at GOSH is great for providing information about procedures. She'll be able to let you know all the details and answer any questions you have. Give her a call or drop the administrator and email and she'll be able to get in touch with you.

Also if you're on Facebook check out Parents of UK children born with BE. This is just for us parents and a place where lots of people have been through what you have x x

Starshinetiger · 13/02/2011 20:32

From starting this thread, I get back on here rarely because the comments are few and far between, so sorry to have missed your posts lots33 and M0lli.

M0lli - can't imagine how stressful it must have been for you having twins as well. Hope you've settled down at home now - boys must be nearly 6 months by now? I found it stressful enough having to leave DS at home so suddenly and be at GOSH with DD.

KMC78 - thanks for the link to the Facebook group - have asked to join. Would just be great to be able to ask other parents who have experience for their insights.

Right, only a quick trip to MN - Sunday night, must drag myself away... Grin

OP posts:
lots33 · 03/03/2011 20:07

Hi Starshinetiger, has your DD has the Kelly prcedure yet? Would love to hear about it if so.

How is everyone else?

DS is 6 months now so Kelly's still a way off...... I am dreading it though as he was so traumatised in December when he had the camera down and hernia done.....

Starshinetiger · 08/03/2011 22:11

Hi lots33 - again not been on regularly. No, DD has not had Kelly yet, but have been reassured/promised by GOSH that it will be August at the latest - she'll be nearly 2.5 by then, hoping sooner. How is your DS doing? I am also dreading op, but know it has to be done, so just try to push it out of day-to-day thoughts. DD really hates the scans (we literally have to pin her down), so don't know how she'll fare with op...

Have you found the facebook group (if you're on there) - I only found it recently, but lots of experience on there.

OP posts:
lots33 · 09/03/2011 12:01

Hi Starshinetiger, no I have not found the Facebook page I did look but couldn't find it. You must be so anxious about the Kelly's coming up....sometimes I want to pretend it is not happening and just make them leave him alone - obviously I know that is not right and I wouldn't do that.

My DS is amazing, happy content baby. Although he had to go to GOSH for camera and hernia op in December and he was really distraught for some weeks after that. I think he knows as soon as we are in the hospital but that is probably my own feelings.

I have a question for you (and anyone else reading) which is personal and please don't feel you have to answer) I just wondered if anyone else's children were born as a result of fertility treatment? We had fertility and donor sperm and I understand from GOSH that another couple also had a BE baby with similar circumstances.........

I hope your daughter is OK please feel free to PM me, take care.

Starshinetiger · 10/03/2011 13:32

Hi Lots - no, my daughter was naturally conceived and I have an older DS, who had no complications at all (well, he had reflux, but lots of babies have that Smile). I do spend a lot of time wondering what I might have done to cause it (even though they reassure you at GOSH that it's nothing you did...). I do go through periods of wanting a 3rd, but the risk of complications does put me off.

Know what you mean about not wanting them to touch your DS and just leave him be. I think that while they are in nappies and perfectly content, that seems so much the better option, but once they start getting interested in the potty it brings home more the challenges.

We went into London last year about 2 weeks after DD had been for a scan and she screamed every time we got on the tube (literally, wanted to lie down on the floor of the tube carriage and scream, not be held) - I did wonder if she associated the tube with going to GOSH Sad

FB page - if you search under part of the group name given above you should find it (I'm rubbish on FB and still found it). There are a fair number of parents on there to share experiences.

OP posts:
lots33 · 10/03/2011 14:32

Oh poor thing it is so hard isn't it? My mum lives a few minutes walk from GOS which is very convenient but she worries that DS will associate visiting her with GOS.

DS is my only child and I'd love more but like you am frightened of complications.

Thanks for the info on FB, I'll search for it.

Take care and thanks Smile

cornishdays · 12/05/2011 09:04

Hi my daughter was born with BE last May we are just looking forward to celebrating her 1 st birthday. She was our 3rd and born at home so it was all a huge shock to 12 hours later find ourselves in GOSH miles from home and our boys. I am really interested to find out about the next procedure the Kellys and any info on what we should be doing to prepare her and ourselves for the post operative care ie exercises etc

newb1 · 03/06/2011 16:16

hi. my daughter is 3 in a couple of months and had the kellys procedure 2 weeks ago. the operation takes around 4 hours and they have to have an epidural in for a couple of days for pain relief, however, my d pulled hers out so had to go on morphine which made her very sick, so i wouldn't recommend that. your child will have a catheter ( which will remain in 2 wks after coming home) 2 stents, removed after 7 days, and a urether stent, which is just to repair things around really.I got my d pushed forward for the kellys because she had constant infections and as a result, scarring of the kidneys. one thing i would suggest, make sure the nurses 'flush' your childs catheter twice a day as one kids bladder exploded due to this not happening. Also, after 2 horrendous spasms ( common whilst having a catheter in) i was told by a more experienced nurse, that my d should have been on medicine to prevent it happening.so make sure you ask for this. were due back in just over a week for the catheter to be removed (hopefully). we were in GOSH for 10 days. very unpleasant time and didnt get better till day 3 when my d picked up, but was very nervous to move, but to get round the stitches and scabs, i just said the doctor needed to draw on you to see where he was putting your belly button. mr cuckows done a brillant job, d loves her new belly button. hope all goes wells. is a very long road but needs to be done at the end of the day.just try to be strong for your little one :-D. hope all this helps, good luck x

mizzlaney · 11/03/2013 15:28

Hi am just new to mumsnet my Kian who is 4 was born with BE and is also under Cuckow at GOSH how is everyone's little ones doing? lots33 i had fertility treatment for my boys before i had Kian was on clomid and had twins but Kian came along naturally before my twins even turned 2 i also heard its more likely in twins and those with fertility x

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