Delayed Surgical Management of an Unusual Classic Bladder Exstrophy Variant

Published:November 24, 2022DOI:
      Anterior abdominal wall defects are rare anomalies that can affect multiple organ systems including gastrointestinal, genitourinary, musculoskeletal, and the neurospinal axis. The highly varied, complex anatomy in this patient population creates a challenging reconstruction scenario that merits careful surgical planning. We present an unusual female variant with an anorectal malformation as well as musculoskeletal and genital abnormalities consistent with classic bladder exstrophy in which the urinary bladder, sphincter, and urethra were largely uninvolved.
      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


        • Eijck FC
        • Aronson DA
        • Hoogeveen YL
        • Wijnen RM
        Past and current surgical treatment of giant omphalocele: outcome of a questionnaire sent to authors.
        J Pediatr Surg. 2011; 46: 482-488
        • Baradaran N
        • Stec AA
        • Schaeffer AJ
        • Gearhart JP
        • Mathews RI
        Delayed primary closure of bladder exstrophy: immediate postoperative management leading to successful outcomes.
        J Urol. 2012; 79: 415-419
        • Mackenzie LL
        Split pelvis in pregnancy.
        Am J Obstet Gynecol. 1935; 29: 255-257
        • Maruf M
        • Benz K
        • Jayman J
        • et al.
        Variant presentations of the exstrophy-epispadias compelx: a 40 year experience.
        J Urol. 2019; 125: 184-190
        • Stec AA
        Embryology and bony and pelvic floor anatomy in the bladder exstrophy-epispadias complex.
        Semin Pediatr Surg. 2011; 20: 66-70
        • Meisheri IV
        • Kasat LS
        • Bahety G
        • Sawant V
        • Kothari P
        • Kumar A
        Pseudoexstrophy of the bladder: a rare variant.
        Pedaitr Surg Int. 2001; 17: 224-225
        • Hejmancik JH
        • King WB
        • Magid MA
        Pseudo-exstrophy of bladder.
        J Urol. 1954; 72: 829-832
        • Mitchell W
        • Venable D
        • Patel AJ
        Urology. 1993; 41: 134-136
        • Otake K
        • Uchida K
        • Inoue M
        • et al.
        Staged management of pseudoexstrophy with omphalocele and wide pubic diastasis.
        J Pedaitr Surg Case Rep. 2014; 2: 388-390
        • Chalfant V
        • Riveros C
        • Elshafei A
        • Stec AA
        An evaluation of perioperative surgical procedures and complications in classic bladder exstrophy patients using the National Surgical Quality Improvement Program-Pediatric (NSQIP-P).
        J Pediatr Urol. 2022; 18 (354.e1-354.e7)
        • Boglione M
        • Aleman S
        • Reusmann A
        • Rubio M
        • Marcelo B
        Giant omphalocele: delayed closure using the San Martin technique following epithelialization of the membrane.
        J Pediatr Surg. 2021; 56: 1247-1251
        • Bauman B
        • Stephens D
        • Gershone H
        • et al.
        Management of giant omphaloceles: a systematic review of methods of staged surgical vs nonoperative delayed closure.
        J Pediatr Surg. 2016; 51: 1725-1730
        • Feng Y-P
        • Yang T-S
        • Chung C-H
        • Chien W-C
        • Wong C-S
        Early childhood general anesthesia exposure associated with later developmental delay: a national population-based cohort study.
        PLoS One. 2020; 15e0238289