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Virtual Pediatric Hospital: Paediapaedia: Exstrophy of the Bladder Paediapaedia: Genitourinary Diseases

Exstrophy of the Bladder

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed

Clinical Presentation:
Not applicable

Failure of closure of the anterior wall of the bladder due to defective embryonic development of the anterior wall of the urogenital sinus and genital tubercle which results in a lower midline abdominal wall defect and open bladder with failure of urethral tubularization (epispadias) and pubic diastasis. Rarely a vesicointestinal fistual or prolapse (cloacal extrophy) is seen in these patients. The anus is ventral in position and may occasionally be imperforate. The genitalia are consistently involved. Rectal prolapse can occur due to poor pelvic musculature.

Not applicable

Imaging Findings:
A plain abdominal film shows diastasis of the symphysis pubis. The kidneys are usually normal.

Diastasis of symphysis pubis

See References Chapter.

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