The parents of a 2-year-old boy who had a repair of exstrophy of the bladder at birth ask when they can begin toilet training their son. The nurse replies based on what knowledge?
a. Most boys in the United States can be toilet trained at age 3 years.
b. Training can begin when he has sufficient bladder capacity.
c. Additional surgery may be necessary to achieve continence.
d. They should begin now because he will require additional time.
ANS: C
After repair of the bladder exstrophy, the child's bladder is allowed to increase capacity. Several surgical procedures may be necessary to create a urethral sphincter mechanism to aid in urination and ejaculation. With the lack of a urinary sphincter, toilet training is unlikely. The child cannot hold the urine in the bladder. Bladder capacity is one component of continence. A functional sphincter is also needed.
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