Myles ahead of bladder exstrophy
After an uneventful pregnancy, Ricky and Amy were shocked to learn
that their son, Myles, had a rare urological disorder known as bladder
exstrophy. He was born with the front of his bladder and the abdominal wall
open. The inside of the bladder was exposed, like a balloon with the top half
missing.
Within 48 hours of Myles' birth, he became the second
child at Children's Memorial to benefit from a recently developed surgical
technique. During a single operation, urological surgeons, William
Kaplan, MD , and Earl
Y. Cheng, MD
, closed the bladder, made repairs to the genital structures, and repositioned
the bladder beneath the pelvic bone where it normally resides. This technique
achieves in one surgery on a newborn what used to take several operations during
the first three-to-five years of the child's life.
For reasons medical science does not understand, in some children with
bladder exstrophy, the bladder does not grow or function normally. For these
patients, surgeons augment the bladder by placing a piece of the child's own
intestine on the top of the bladder. While bladder augmentation is quite
successful in increasing bladder capacity, the intestinal patch does not grow
and function like normal bladder tissue. Consequently, many bladder augmentation
patients are at risk of developing infections, bladder stones and other
problems. Myles' doctors will need to carefully monitor his progress to see if
he will require bladder augmentation in the future.
Cheng hopes that through laboratory research, within the next decade he will
find a better solution than bladder augmentation for his patients. An associate
professor of urology at Northwestern University's Feinberg School of Medicine,
he is a surgeon-scientist in urology research at Children's Memorial.
Surgeon-scientists offer a unique and important bridge between basic science
research and patient care. "Surgeons see problems in the operating room that we
know we can't fix and wonder if there is a better way to treat the patient,"
says Cheng. "I'm able to take the questions that arise in surgery and see if we
can find an answer in the lab."
Researchers at Children's Memorial and other institutions have had success in
isolating animal bladder cells, growing the cells in the lab on specialized
membranes until they form a sheet of tissue, and then reimplanting the composite
tissue back into the animal's bladder. The body is then able to further
integrate the composite with existing bladder tissue. If this technology can be
successfully developed for humans, it could help children with bladder exstrophy
and other bladder disorders achieve more normal bladder function than current
surgical reconstruction offers. Cheng hopes that the research will also lead to
new treatment options for other types of congenital disorders that involve the
bladder, such as spina bifida.
"Our work shows great promise for the future, but I caution parents that it
is still in very early stages," Cheng says. "It may be a decade before we can
safely transplant a laboratory- engineered bladder into a child."
To foster these kinds of research efforts, Children's Memorial hopes to
establish 10 endowed surgeon-scientist positions through philanthropy of
approximately $1.5 million for each endowed chair.
Myles' family supports this vision. "A year ago, we didn't even know bladder
exstrophy existed," says Amy. "We need to raise funds and awareness now,
so that it can help Myles and other children like him — soon."
Children's Memorial Hospital seeks philanthropic funding to
enhance its programs and services. As a proud partner of the Children's Miracle
Network (CMN), all funds raised in the Chicago area through CMN also benefit
Children's Memorial. To find out how your support can help the hospital better
serve children and families, please contact the Children's Memorial Foundation
at 773.880.4237 or Foundation@childrensmemorial.org.