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J R Soc Med 1996;89:39-46
© 1996 Royal Society of Medicine

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Journal of the Royal Society of Medicine, Vol 89, Issue 1 39-46, Copyright © 1996 by Royal Society of Medicine

ORIGINAL ARTICLES

Bladder exstrophy from childhood into adult life

J Ben-Chaim, SG Docimo, RD Jeffs and JP Gearhart
Department of Urology, Johns Hopkins Hospital and University School of Medicine, Baltimore, MD 21287-2101, USA.

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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