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J R Soc Med. 1996 January; 89(1): 39P–46P.
PMCID: PMC1295642

Bladder exstrophy from childhood into adult life.

Abstract

Exstrophy of the bladder is rare and the incidence of bladder exstrophy is calculated to be from 1 per 30,000 to 50,000 live births with male to female ratio ranging from 1.5-5 to 1(1-4). It was found that persistence or overgrowth of the cloacal membrane on the lower anterior abdominal area, prevents normal mesenchymal ingrowth. This causes divergence of the lower abdominal muscular structures and forces the genital ridges to fuse caudal to the cloacal membrane. The stage of ingrowth of the urorectal septum at the time of rupture determines whether one will produce an exstrophic urinary tract alone (classic bladder exstrophy or epispadias) or cloacal exstrophy with the hindgut interposed between the hemibladders.

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Selected References

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  • Epidemiology of bladder exstrophy and epispadias: a communication from the International Clearinghouse for Birth Defects Monitoring Systems. Teratology. 1987 Oct;36(2):221–227. [PubMed]
  • Lattimer JK, Smith MJ. Exstrophy closure: a followup on 70 cases. J Urol. 1966 Mar;95(3):356–359. [PubMed]
  • Jeffs RD, Guice SL, Oesch I. The factors in successful exstrophy closure. J Urol. 1982 May;127(5):974–976. [PubMed]
  • MUECKE EC. THE ROLE OF THE CLOACAL MEMBRANE IN EXSTROPHY: THE FIRST SUCCESSFUL EXPERIMENTAL STUDY. J Urol. 1964 Dec;92:659–667. [PubMed]
  • Ambrose SS, O'Brien DP., 3rd Surgical embryology of the exstrophy-epispadias complex. Surg Clin North Am. 1974 Dec;54(6):1379–1390. [PubMed]
  • Shapiro E, Lepor H, Jeffs RD. The inheritance of the exstrophy-epispadias complex. J Urol. 1984 Aug;132(2):308–310. [PubMed]
  • Ives E, Coffey R, Carter CO. A family study of bladder exstrophy. J Med Genet. 1980 Apr;17(2):139–141. [PMC free article] [PubMed]
  • Jaffe R, Schoenfeld A, Ovadia J. Sonographic findings in the prenatal diagnosis of bladder exstrophy. Am J Obstet Gynecol. 1990 Mar;162(3):675–678. [PubMed]
  • Barth RA, Filly RA, Sondheimer FK. Prenatal sonographic findings in bladder exstrophy. J Ultrasound Med. 1990 Jun;9(6):359–361. [PubMed]
  • Muecke EC, Currarino G. Congenital widening of the pubic symphysis: associated clinical disorders and roentgen anatomy of affected bony pelves. Am J Roentgenol Radium Ther Nucl Med. 1968 May;103(1):179–185. [PubMed]
  • Woodhouse CR, Kellett MJ. Anatomy of the penis and its deformities in exstrophy and epispadias. J Urol. 1984 Dec;132(6):1122–1124. [PubMed]
  • Husmann DA, McLorie GA, Churchill BM, Ein SH. Inguinal pathology and its association with classical bladder exstrophy. J Pediatr Surg. 1990 Mar;25(3):332–334. [PubMed]
  • Jones HW., Jr An anomaly of the external genitalia in female patients with exstrophy of the bladder. Am J Obstet Gynecol. 1973 Nov 15;117(6):748–756. [PubMed]
  • Krisiloff M, Puchner PJ, Tretter W, Macfarlane MT, Lattimer JK. Pregnancy in women with bladder exstrophy. J Urol. 1978 Apr;119(4):478–479. [PubMed]
  • Ansell JS. Surgical treatment of exstrophy of the bladder with emphasis on neonatal primary closure: personal experience with 28 consecutive cases treated at the University of Washington hospitals from 1962 to 1977: techniques and results. J Urol. 1979 May;121(5):650–653. [PubMed]
  • Oesterling JE, Jeffs RD. The importance of a successful initial bladder closure in the surgical management of classical bladder exstrophy: analysis of 144 patients treated at the Johns Hopkins Hospital between 1975 and 1985. J Urol. 1987 Feb;137(2):258–262. [PubMed]
  • Gearhart JP, Jeffs RD. State-of-the-art reconstructive surgery for bladder exstrophy at the Johns Hopkins Hospital. Am J Dis Child. 1989 Dec;143(12):1475–1478. [PubMed]
  • Gökçora IH, Yazar T. Bilateral transverse iliac osteotomy in the correction of neonatal bladder extrophies. Int Surg. 1989 Apr-Jun;74(2):123–125. [PubMed]
  • Sponseller PD, Gearhart JP, Jeffs RD. Anterior innominate osteotomies for failure or late closure of bladder exstrophy. J Urol. 1991 Jul;146(1):137–140. [PubMed]
  • Frey P, Cohen SJ. Anterior pelvic osteotomy. A new operative technique facilitating primary bladder exstrophy closure. Br J Urol. 1989 Dec;64(6):641–643. [PubMed]
  • Schmidt AH, Keenen TL, Tank ES, Bird CB, Beals RK. Pelvic osteotomy for bladder exstrophy. J Pediatr Orthop. 1993 Mar-Apr;13(2):214–219. [PubMed]
  • Duckett JW. Use of paraexstrophy skin pedicle grafts for correction of exstrophy and epispadias repair. Birth Defects Orig Artic Ser. 1977;13(5):175–179. [PubMed]
  • Gearhart JP, Peppas DS, Jeffs RD. Complications of paraexstrophy skin flaps in the reconstruction of classical bladder exstrophy. J Urol. 1993 Aug;150(2 Pt 2):627–630. [PubMed]
  • Jordan GH, Gilbert DA. Operative procedures for epispadias and exstrophy of the bladder. Semin Urol. 1987 Nov;5(4):243–250. [PubMed]
  • Lowe FC, Jeffs RD. Wound dehiscence in bladder exstrophy: an examination of the etiologies and factors for initial failure and subsequent success. J Urol. 1983 Aug;130(2):312–315. [PubMed]
  • Husmann DA, McLorie GA, Churchill BM. Closure of the exstrophic bladder: an evaluation of the factors leading to its success and its importance on urinary continence. J Urol. 1989 Aug;142(2 Pt 2):522–543. [PubMed]
  • Hendren WH. Nonrefluxing colon conduit for temporary or permanent urinary diversion in children. J Pediatr Surg. 1975 Jun;10(3):381–398. [PubMed]
  • Gearhart JP, Jeffs RD. Bladder exstrophy: increase in capacity following epispadias repair. J Urol. 1989 Aug;142(2 Pt 2):525–543. [PubMed]
  • Gearhart JP, Jeffs RD. The use of parenteral testosterone therapy in genital reconstructive surgery. J Urol. 1987 Oct;138(4 Pt 2):1077–1078. [PubMed]
  • Hendren WH. Penile lengthening after previous repair of epispadias. J Urol. 1979 Apr;121(4):527–534. [PubMed]
  • Thomalla JV, Mitchell ME. Ventral preputial island flap technique for the repair of epispadias with or without exstrophy. J Urol. 1984 Nov;132(5):985–987. [PubMed]
  • Gearhart JP, Leonard MP, Burgers JK, Jeffs RD. The Cantwell-Ransley technique for repair of epispadias. J Urol. 1992 Sep;148(3):851–854. [PubMed]
  • Gearhart JP, Sciortino C, Ben-Chaim J, Peppas DS, Jeffs RD. The Cantwell-Ransley epispadias repair in exstrophy and epispadias: lessons learned. Urology. 1995 Jul;46(1):92–95. [PubMed]
  • Canning DA, Gearhart JP, Peppas DS, Jeffs RD. The cephalotrigonal reimplant in bladder neck reconstruction for patients with exstrophy or epispadias. J Urol. 1993 Jul;150(1):156–158. [PubMed]
  • Gearhart JP, Williams KA, Jeffs RD. Intraoperative urethral pressure profilometry as an adjunct to bladder neck reconstruction. J Urol. 1986 Nov;136(5):1055–1056. [PubMed]
  • Connor JP, Hensle TW, Lattimer JK, Burbige KA. Long-term followup of 207 patients with bladder exstrophy: an evolution in treatment. J Urol. 1989 Sep;142(3):793–796. [PubMed]
  • Gearhart JP, Peppas DS, Jeffs RD. The failed exstrophy closure: strategy for management. Br J Urol. 1993 Feb;71(2):217–220. [PubMed]
  • Gearhart JP, Leonard MP, Burgers JK, Jeffs RD. The Cantwell-Ransley technique for repair of epispadias. J Urol. 1992 Sep;148(3):851–854. [PubMed]
  • Stöckle M, Becht E, Voges G, Riedmiller H, Hohenfellner R. Ureterosigmoidostomy: an outdated approach to bladder exstrophy? J Urol. 1990 Apr;143(4):770–775. [PubMed]
  • Strachan JR, Woodhouse CR. Malignancy following ureterosigmoidostomy in patients with exstrophy. Br J Surg. 1991 Oct;78(10):1216–1218. [PubMed]
  • Gittes RF. Carcinogenesis in ureterosigmoidostomy. Urol Clin North Am. 1986 May;13(2):201–205. [PubMed]
  • Schwarz GR, Jeffs RD. Ileal conduit urinary diversion in children: computer analysis of followup from 2 to 16 years. J Urol. 1975 Aug;114(2):285–288. [PubMed]
  • Arap S, Martins Giron A, Menezes de Góes G. Initial results of the complete reconstruction of bladder exstrophy. Urol Clin North Am. 1980 Jun;7(2):477–491. [PubMed]
  • Leonard MP, Gearhart JP, Jeffs RD. Continent urinary reservoirs in pediatric urological practice. J Urol. 1990 Aug;144(2 Pt 1):330–333. [PubMed]
  • Stein R, Stöckle M, Fisch M, Nakai H, Müller SC, Hohenfellner R. The fate of the adult exstrophy patient. J Urol. 1994 Nov;152(5 Pt 1):1413–1416. [PubMed]
  • Hanna MK, Williams DI. Genital function in males with vesical exstrophy and epispadias. Br J Urol. 1972 Apr;44(2):169–174. [PubMed]
  • Woodhouse CR, Ransley PG, Williams DI. The patient with exstrophy in adult life. Br J Urol. 1983 Dec;55(6):632–635. [PubMed]

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