Pediatric Case Reports| Volume 171, P212-215, January 2023

Synchronous Testicular Sperm Extraction in the Setting of Bladder Exstrophy

  • John Weaver
    Address correspondence to: John Weaver, M.D., Assistant Professor in Urologic Surgery, Case Western Reserve University School of Medicine, Attending Pediatric Urologist, Rainbow Babies and Children's Hospital, 11100 Euclid Ave, Cleveland, OH 44106.
    Case Western Reserve University School of Medicine/Rainbow Babies and Children's Hospital, Division of Urology, Cleveland, OH
    Search for articles by this author
  • Puneet Masson
    University of Pennsylvania School of Medicine, Division of Urology, Cleveland, OH
    Search for articles by this author


      Bladder exstrophy (BE) is a devastating congenital abnormality of the urinary tract in which infants are born with the urinary bladder extruded through their abdominal wall, a urethra that is open dorsally, and significant secondary abnormalities of the genitalia. We present a male patient with BE who suffered from infertility and after a long course of failed attempts with assisted reproductive technology ultimately benefitted from a synchronous testicular sperm extraction. We review the literature surrounding assisted reproductive techniques in the setting of bladder exstrophy and comment on innovative technologies that may benefit this population.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Urology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Shapiro E
        • Jeffs RD
        • Gearhart JP
        • et al.
        Muscarinic cholinergic receptors in bladder exstrophy: insights into surgical management.
        J Urol. 1985; 134: 308-310
        • Ebert AK
        • Bals-Pratsch M
        • Seifert B
        • et al.
        Genital and reproductive function in males after functional reconstruction of the exstrophy-epispadias complex–long-term results.
        Urology. 2008; 72 (discussion 569-70): 566-569
        • Ebert AK
        • Schott G
        • Bals-Pratsch M
        • et al.
        Long-term follow-up of male patients after reconstruction of the bladder-exstrophy-epispadias complex: psychosocial status, continence, renal and genital function.
        J Pediatr Urol. 2010; 6: 6-10
        • Gearhart JP
        Exstrophy epispadias complex.
        (eds)in: DR Partin W Kavoussi LR Peters CA Wein AJ Campbell Walsh Wein Urology. Elsevier, Philadelphia PA2021
        • Gearhart JP
        • Jeffs RD
        State-of-the-art reconstructive surgery for bladder exstrophy at the Johns Hopkins Hospital.
        Am J Dis Child. 1989; 143: 1475-1478
        • Hanna MK
        • Williams DI
        Genital function in males with vesical exstrophy and epispadias.
        Br J Urol. 1972; 44: 169-174
        • Stein R
        • Stockle M
        • Fisch M
        • et al.
        The fate of the adult exstrophy patient.
        J Urol. 1994; 152: 1413-1416
        • La Vignera S
        • Vicari E
        • Condorelli RA
        • et al.
        Male accessory gland infection and sperm parameters (review).
        Int J Androl. 2011; 34: e330-e347
        • Agarwal A
        • Said TM.
        Role of sperm chromatin abnormalities and DNA damage in male infertility.
        Hum Reprod Update. 2003; 9: 331-345
        • Lewis SE
        • Aitken RJ
        • Conner SJ
        • et al.
        The impact of sperm DNA damage in assisted conception and beyond: recent advances in diagnosis and treatment.
        Reprod Biomed Online. 2013; 27: 325-337
        • Partin AW
        • Dmochowski RR
        • Kavoussi LR
        • Peters C
        Campbell-Walsh-Wein Urology.
        Twelfth ed. Elsevier, Philadelphia PA2021: 1428-1452
        • Tesarik J
        • Greco E
        • Mendoza C.
        Late, but not early, paternal effect on human embryo development is related to sperm DNA fragmentation.
        Hum Reprod. 2004; 19: 611-615
        • Le MT
        • Nguyen TT
        • Nguyen TT
        • et al.
        Does conventional freezing affect sperm DNA fragmentation?.
        Clin Exp Reprod Med. 2019; 46: 67-75
        • D'Hauwers KW
        • Feitz WF
        • Kremer JA
        Bladder exstrophy and male fertility: pregnancies after ICSI with ejaculated or epididymal sperm.
        Fertil Steril. 2008; 89: 387-389