Abstract
The exstrophy complex represents a spectrum of congenital abnormalities that includes the following conditions: epispadias, classic bladder exstrophy, and cloacal exstrophy. These three deformations comprise a continuum with epispadias representing the least severe, classic bladder exstrophy the most common, and cloacal exstrophy the most severe. Cloacal exstrophy is extremely rare, occurring in approximately 1 in every 200,000 to 400,000 live births (Ziegler et al, 1986). Although primarily a ventral abdominal wall defect, cloacal exstrophy is associated with varying degrees of abnormalities in the genitourinary tract, bowel, spine, and lower extremities. Until recently, most children with cloacal exstrophy did not survive infancy because of the complex multiple system abnormalities resulting in fluid and nutritional defects. In 1960, Rickham reported the first survivor with cloacal exstrophy (Rickham, 1960). Primarily due to advances in perinatal care and total parenteral nutrition, survival is now feasible in greater than 90% of patients born with cloacal exstrophy. Thus, the focus is now directed at quality of life issues in these complex patients.
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References
Grady RW, Can’ MC, Mitchell ME. Complete primary closure of bladder exstrophy.Urol Clin N Amer26(1):95, 1999.
Husmann DA, McLorie GA, Churchill BM. Phallic reconstruction in cloacal exstrophy.J Uro!142:563, 1989.
McLaughlin KP, Rink RC, Kalsbeck JE, Keating MA, Adams MC, King SJ, Luerssen TG. Cloacal exstrophy: The neurological implications.J Uro!154:782, 1995.
Mitchell ME, Brito CG, Rink RC. Cloacal exstrophy reconstruction for urinary continence.J Urol144:554, 1990.
Mitchell ME, Bagli DJ. Complete penile disassembly for epispadias repair: The Mitchell technique.J Uro!155:300,1996.
Money J. Ablatio Penis: Normal male infant sex-reassigned as a girl.Arch Sex Behav4:65, 1975.
Reiner WG. Psychosocial concerns in Classical and Cloacal Exstrophy patients.Dial Ped Uro122:3, 1999. Rickham PP. Vesico-intestinal fissure.Arch Dis Child35:97, 1960.
Zeigler MM, Duckett JW, Howell CG. Cloacal Exstrophy, in:Pediatric SurgeryKJ Welch et al, ed., Year Book Medical Publishers, Chicago, 1986.
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© 2002 Springer Science+Business Media New York
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Mitchell, M.E., Plaire, C. (2002). Management of Cloacal Exstrophy. In: Zderic, S.A., Canning, D.A., Carr, M.C., Snyder, H.M. (eds) Pediatric Gender Assignment. Advances in Experimental Medicine and Biology, vol 511. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-0621-8_16
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DOI: https://doi.org/10.1007/978-1-4615-0621-8_16
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