Cloacal exstrophy is a severe birth defect wherein much of the abdominal organs (the bladder and intestines) are exposed. It often causes the splitting of both male and femalegenitalia (specifically, the penis and clitoris respectively), and the anus is occasionally sealed.
It is extremely rare at only 1 in 250,000 births being afflicted with it, and its cause is unknown.
In females with cloacalexstrophy, the clitoris is divided in two halves, again at the base of the bladder, and the pubic bones are widely split.
A dehiscence in the exstrophy population typically means that the pubic bones and abdominal wall closure have split apart and the bladder is reexstruded onto the abdomen wall.
In the bladderexstrophy population, osteotomies are used to help reconstruct the pelvic bones and the pelvic floor which removes tension from the abdominal wall and bladder closure thereby aiding in the success of the exstrophy reconstruction.
Bladderexstrophy is a defect of the caudal fold of the anterior abdominal wall; a small defect may cause epispadias alone, whilst a large defect leads to exposure of the posterior bladder wall.
Cloacalexstrophy (also referred to as OEIS complex) is the association of an omphalocele, exstrophy of the bladder, imperforated anus, and spinal defects such as meningomyelocele.
Bladderexstrophy should be suspected when, in the presence of normal amniotic fluid, the fetal bladder is not visualized (the filling cycle of the bladder is normally in the range of 15 min); an echogenic mass is seen protruding from the lower abdominal wall, in close association with the umbilical arteries.
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