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Prune Belly Syndrome: A Focused Physical Assessment

Woods, Amanda G. RN, MSN, CNNP1,2; Brandon, Debra H. RN, PhD1,3

Section Editor(s): MERRITT, LINDA MSN, RNC

doi: 10.1097/01.ANC.0000278211.95767.05
Focus on the Physical

Prune belly syndrome, a rare congenital anomaly, exists almost exclusively in males and consists of genital and urinary abnormalities with partial or complete absence of abdominal wall musculature. The syndrome, caused by urethral obstruction early in development, is the result of massive bladder distention and urinary ascites, leading to degeneration of the abdominal wall musculature and failure of testicular descent. The impaired elimination of urine from the bladder leads to oligohydramnios, pulmonary hypoplasia, and Potter's facies. The syndrome has a broad spectrum of affected anatomy with different levels of severity. The exact etiology of prune belly syndrome is unknown, although several embryologic theories attempt to explain the anomaly. With advances in prenatal screening techniques, the diagnosis and possible treatment of prune belly syndrome can occur before birth, although controversy exists on the proper management of prune belly syndrome. This article explores the theories behind the pathophysiology and embryology of prune belly syndrome and its multisystemic effects on the newborn infant. Specific attention is paid to presentation, clinical features, head-to-toe physical assessment, family support, and nursing care of infants with prune belly syndrome.

From 1Duke University School of Nursing, Durham, NC; 2Women's Hospital, Greensboro, NC; and 3Duke University Health System, Durham, NC.

Address correspondence to Amanda G. Woods, Women's Hospital of Greensboro, 801 Green Valley Road, Greensboro, NC 27407.

E-mail: woodsland@yahoo.com

The authors have no significant ties, financial or otherwise, to any company that might have an interest in the publication of this educational activity.

© 2007 National Association of Neonatal Nurses