Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with the classic triad of Prune Belly Syndrome: deficiency of abdominal wall musculature, urinary tract malformations (megacystis/hydroureteronephrosis), and bilateral cryptorchidism. History significant for prenatal ultrasound findings of fetal ascites or urinary tract dilation. Current complaints include [urinary frequency/stasis/recurrent UTIs/constipation].
Clinical Examination Findings
Physical examination reveals a lax, wrinkled abdominal wall with visible bowel loops (prune-like appearance). Palpation confirms absence of abdominal muscle tone. Genitourinary exam confirms bilateral undescended testes (cryptorchidism) and potential bladder distension. Auscultation of heart and lungs to rule out associated congenital anomalies (e.g., VSD, pulmonary hypoplasia).
Treatment Protocol
Management plan includes: 1. Prophylactic antibiotics for recurrent UTI prevention. 2. Surgical intervention: Orchiopexy for cryptorchidism, abdominal wall reconstruction (abdominoplasty) for functional/cosmetic improvement, and urological reconstruction (ureteral tapering/reimplantation) as indicated by renal function and degree of hydroureteronephrosis. 3. Close monitoring of renal function markers (creatinine, GFR).