Prune belly syndrome
Prune belly syndrome is a group of rare birth defects that involves these three main problems:
- Poor development of the abdominal muscles, causing the skin of the belly area to wrinkle like a prune
-
Undescended testicles
Undescended testicles
Undescended testicle occurs when one or both testicles fail to move into the scrotum before birth.
Read Article Now Book Mark Article - Urinary tract problems
Causes
The exact causes of prune belly syndrome are unknown. The condition affects mostly boys.
While in the womb (uterus), the developing baby's abdomen swells with fluid. Often, the cause is a problem in the urinary tract. The fluid disappears after birth, leading to a wrinkled abdomen that looks like a prune. This appearance is more noticeable due to the lack of abdominal muscles.
Symptoms
Weak abdominal muscles can cause:
-
Constipation
Constipation
Constipation in infants and children means they have hard stools or have problems passing stools. A child may have pain while passing stools or may ...
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- Difficulties coughing
Urinary tract problems can cause difficulty urinating.
Exams and Tests
A woman who is pregnant with a baby who has prune belly syndrome may not have enough amniotic fluid (the fluid that surrounds the fetus). This can cause the infant to have lung problems from being compressed in the womb.
An ultrasound done during pregnancy may show that the baby has a swollen bladder or enlarged kidney.
Ultrasound done during pregnancy
A pregnancy ultrasound is an imaging test that uses sound waves to create a picture of how a baby is developing in the womb (uterus). It is also use...
Read Article Now Book Mark ArticleIn some cases, a pregnancy ultrasound may also help determine if the baby has:
- Heart problems
- Abnormal bones or muscles
- Stomach and intestinal problems
- Underdeveloped lungs
The following tests may be performed on the baby after birth to diagnose the condition:
- Blood tests
-
Intravenous pyelogram (IVP)
Intravenous pyelogram
An intravenous pyelogram (IVP) is a special x-ray exam of the kidneys, bladder, and ureters (the tubes that carry urine from the kidneys to the bladd...
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Ultrasound
Ultrasound
Ultrasound uses high-frequency sound waves to make images of organs and structures inside the body.
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Voiding cystourethrogram (VCUG)
Voiding cystourethrogram
A voiding cystourethrogram is an x-ray study of the bladder and urethra. It is done while the bladder is emptying.
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X-ray
X-ray
X-rays are a type of electromagnetic radiation, just like visible light. An x-ray machine sends individual x-ray waves through the body. The images...
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CT scan
CT scan
A computed tomography (CT) scan is an imaging method that uses x-rays to create pictures of cross-sections of the body. Related tests include:Abdomin...
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Treatment
Early surgery is recommended to fix weak abdominal muscles, urinary tract problems, and undescended testicles.
The baby may be given antibiotics to treat or help prevent urinary tract infections.
Support Groups
More information and support for people with prune belly syndrome and their families can be found at:
- Prune Belly Syndrome Network -- prunebelly.org
Outlook (Prognosis)
Prune belly syndrome is a serious and often life-threatening problem.
Many infants with this condition are either stillborn or die within the first few weeks of life. The cause of death is from severe lung or kidney problems, or from a combination of birth problems.
Stillborn
A stillbirth is when a baby dies in the womb during the last 20 weeks of pregnancy. A miscarriage is a fetal loss in the first half of pregnancy...
Read Article Now Book Mark ArticleSome newborns survive and can develop normally. Others continue to have many medical and developmental problems.
Possible Complications
Complications depend on the related problems. The most common are:
- Constipation
- Bone deformities (clubfoot, dislocated hip, missing limb, finger, or toe, funnel chest)
Clubfoot
Clubfoot is a condition that involves both the foot and lower leg in which the foot turns inward and downward. It is a congenital condition, which m...
Read Article Now Book Mark ArticleFunnel chest
Pectus excavatum is a medical term that describes an abnormal formation of the rib cage that gives the chest a caved-in or sunken appearance....
Read Article Now Book Mark Article - Disease of the urinary tract (may need dialysis and a kidney transplant)
Dialysis
Dialysis treats end-stage kidney failure. It removes harmful substances from the blood when the kidneys cannot. This article focuses on peritoneal d...
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Undescended testicles can lead to infertility or cancer.
Infertility
Infertility means you cannot get pregnant (conceive). There are 2 types of infertility:Primary infertility refers to couples who have not become preg...
Read Article Now Book Mark ArticleWhen to Contact a Medical Professional
Prune belly syndrome is usually diagnosed before birth or when the baby is born.
If you have a child with diagnosed prune belly syndrome, contact your health care provider at the first sign of a urinary tract infection or other urinary symptoms.
If a pregnancy ultrasound shows that your baby has a swollen bladder or enlarged kidneys, talk to a specialist in high-risk pregnancy or perinatology.
Prevention
There is no known way to prevent this condition. If the baby is diagnosed with a urinary tract obstruction before birth, in rare cases, surgery during the pregnancy may help prevent the problem from progressing to prune belly syndrome.
Reviewed By
Anna C. Edens Hurst, MD, MS, Associate Professor in Medical Genetics, The University of Alabama at Birmingham, Birmingham, AL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Denes FT, Lopes RI. Prune-belly syndrome. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 32.
Di Carlo HN, Crigger CB. Obstruction of the urinary tract. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 577.
Rowe CK, Merguerian PA. Developmental abnormalities of the genitourinary system. In: Gleason CA, Sawyer T, eds. Avery's Diseases of the Newborn. 11th ed. Philadelphia, PA: Elsevier; 2024:chap 76.
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