Epispadias-Exstrophy Complex

  • Erich SorantinEmail author
  • Sandra Abou Samaan
Part of the Medical Radiology book series (MEDRAD)


The epispadias-exstrophy complex represents a spectrum of malformations ranging from epispadias to cloacal exstrophy (Wood 1990). The most common entities of this complex and their frequencies are listed in Table 1 (Duckett and Cladamone 1985).


  1. Ahmed S, Abu Daia J (1998) Exstrophic abdominal wall defect without bladder exstrophy (pseudo-exstrophy). Br J Urol 81:762–763CrossRefPubMedGoogle Scholar
  2. Ben-Chaim J, Gearhart JP (1996) Current management of bladder exstrophy. Tech Urol 2:22–33PubMedGoogle Scholar
  3. Ben-Chaim J, Docimo S, Jeffs RD (1996) Bladder exstrophy from childhood into adult life. J R Soc Med 89:39–46CrossRefGoogle Scholar
  4. Borwankar SS, Kasat LS, Naregal A (1998) Covered exstrophy: a rare variant. Pediatr Surg Int 14:129–130CrossRefPubMedGoogle Scholar
  5. Cadeddu JA, Benson JE, Silver RI (1997) Spinal abnormalities in classic bladder exstrophy. Br J Urol 79:975–978CrossRefPubMedGoogle Scholar
  6. Canning DA (1996) Bladder exstrophy: the case for primary bladder reconstruction. J Urol 48:831–834CrossRefGoogle Scholar
  7. Connolly JA, Peppas DS, Jeffs RD (1995) Prevalence and repair of inguinal hernias in children with bladder exstrophy. J Urol 154:1900–1901CrossRefPubMedGoogle Scholar
  8. Crankscon SJ, Ahmed S (1997) Female bladder exstrophy. Int Urogynecol J Pelvic Floor Dysfunct 8:98–104CrossRefGoogle Scholar
  9. Currarino G, Wood B, Majd M (1993) The genitourinary tract and retroperitoneum–epispadias-exstrophy complex. In: Silverman F, Kuhn J (eds) Caffey’s pediatric X-ray diagnosis. An integrated imaging approach. Mosby, St. Louis, pp 1298–1301Google Scholar
  10. Dickson AP (2014) The management of bladder exstrophy: the Manchester experience. J Pediatr Surg 49(2):244–250CrossRefPubMedGoogle Scholar
  11. Diamond DA, Bauer SB, Dinlenc C (1999) Normal urodynamics in patients with bladder exstrophy: are they achievable? J Urol 162:841–845CrossRefPubMedGoogle Scholar
  12. Duckett JW, Cladamone AA (1985) Bladder and urachus. In: Kelalis PP, King LR, Belman AB (eds) Clinical pediatric urology. Saunders, Philadelphia, pp 726–742Google Scholar
  13. Duffy PG (1995) Bladder exstrophy. Semin Pediatr Surg 5:129–132Google Scholar
  14. Fotter R (1992) Functional disorders of the lower urinary tract: urodynamic and radiological diagnosis. In: Thomsen HS (ed) European uroradiology 1992. FADL, Copenhagen, pp 127–132Google Scholar
  15. Fotter R (1994) Children. In: Dalla Palma L, Thomsen HS (eds) European uroradiology 1994. FADL, Copenhagen, pp 120–127Google Scholar
  16. Fotter R (1996) Neurogenic bladder in infants and children–a new challenge for the radiologist. Abdom Imaging 21:534–540CrossRefPubMedGoogle Scholar
  17. Fotter R, Kopp W, Klein E, Höllwarth M, Uray E (1986) Unstable bladder in children: functional evaluation by modified voiding cystourethrography. Radiology 161:811–813CrossRefPubMedGoogle Scholar
  18. Gargollo PC, Borer JG, Retik AB (2005) Magnetic resonance imaging of pelvic musculoskeletal and genitourinary anatomy in patients before and after complete repair of bladder exstrophy. J Urol 174:1559–1566CrossRefPubMedGoogle Scholar
  19. Hollowell JG, Hill PD, Duffy PG (1992) Lower urinary tract function after exstrophy closure. Pediatr Nephrol 6:428–432CrossRefPubMedGoogle Scholar
  20. Husmann DA, McLorie GA, Churchill BM, Ein SH (1990) Inguinal pathology and is association with classical bladder exstrophy. J Pediatr Surg 25:332–334CrossRefPubMedGoogle Scholar
  21. Husmann DA, McLorie GA, Churchill BM (1993) Hypertension following primary bladder closure for vesical exstrophy. J Pediatr Surg 28:239–241CrossRefPubMedGoogle Scholar
  22. Inouye BM, Massanyi EZ, Di Carlo H, Shah BB, Gearhart JP (2013) Modern management of bladder exstrophy repair. Curr Urol Rep 14(4):359–365CrossRefPubMedGoogle Scholar
  23. Johnson P, Sarin YK, Kapoor R (1995) Inferior vesical fissure. J Urol 154:1478CrossRefPubMedGoogle Scholar
  24. Kelly CH (1998) Exstrophy and epispadias: Kelly’s method of repair. In: O’Neill JA (ed) Pediatric surgery, 5th edn. Mosby, St. Louis, pp 1732–1759Google Scholar
  25. Lizscano-Gil LA, Garcia-Cruz D, Sanchez-Corona J (1995) Omphalocele–exstrophy–imperforate anus–spina bifida complex in a male prenatally exposed to diazepam. Arch Med Res 26:95–96Google Scholar
  26. Mathews R, Wills M, Perlman E (1999) Neural innervation of the newborn exstrophic bladder: an immunohistochemical study. J Urol 162:506–508CrossRefPubMedGoogle Scholar
  27. Muecke EC (1964) The role of the cloacal membrane in exstrophy: the first successful experimental study. J Urol 92:659CrossRefPubMedGoogle Scholar
  28. Perren F, Frey P (1998) The exstrophy-epispadias complex in the duplicated lower urinary tract. J Urol 159:1681–1683CrossRefPubMedGoogle Scholar
  29. Riccabona M (2004) Pediatric MRU – its potential and its role in the diagnostic work-up of upper urinary tract dilatation in infants and children. World J Urol 22;79–87Google Scholar
  30. Riccabona M, Avni FE, Blickman JG (2008) Imaging recommendations in paediatric uroradiology: minutes of the ESPR workgroup session on urinary tract infection, fetal hydronephrosis, urinary tract ultrasonography and voiding cystourethrography, Barcelona, Spain, June 2007. Pediatr Radiol 38(2):138–145CrossRefPubMedGoogle Scholar
  31. Riccabona M, Avni FE, Blickman JG (2009) Imaging recommendations in paediatric uroradiology. Minutes of the ESPR uroradiology task force session on childhood obstructive uropathy, high-grade fetal hydronephrosis, childhood haematuria, and urolithiasis in childhood. ESPR Annual Congress, Edinburgh, UK, June 2008. Pediatr Radiol 39(8):891–898CrossRefPubMedGoogle Scholar
  32. Riccabona M, Avni FE, Dacher JN (2010) ESPR uroradiology task force and ESUR paediatric working group: imaging and procedural recommendations in paediatric uroradiology, part III. Minutes of the ESPR uroradiology task force minisymposium on intravenous urography, uro-CT and MR-urography in childhood. Pediatr Radiol 40:1315–1320CrossRefPubMedGoogle Scholar
  33. Riccabona M, Nelson TR, Pretorius DH, Davidson TE (1996) In vivo three–dimensional sonographic measurement of organ volume: validation in the urinary bladder. J Ultrasound Med 15:627–632CrossRefPubMedGoogle Scholar
  34. Sahoo SP, Gangopadhyay AN, Sinha CK (1997) Covered exstrophy: a rare variant of classical bladder exstrophy. Scand J Urol Nephrol 31:103–106CrossRefPubMedGoogle Scholar
  35. Salem HK, Eisa M (2012) Long-term follow-up (18–35 years) of male patients with history of bladder exstrophy (BE) repair in childhood: erectile function and fertility potential outcome. J Sex Med 9(5):1466–1472. doi: 10.1111/j1743-6109-2011-02536.x CrossRefPubMedGoogle Scholar
  36. Smith NM, Chambers HM, Furness ME (1992) The OEIS complex (omphalocele-exstrophy–imperforate anus–spinal defects): recurrence in sibs. J Med Genet 29:730–732CrossRefPubMedPubMedCentralGoogle Scholar
  37. Sponseller BD, Bisson LJ, Gearhart JP (1995) The anatomy of the pelvis in the exstrophy complex. J Bone Joint Surg Am 77:177–189CrossRefPubMedGoogle Scholar
  38. Sripathi V, Sen S, Ahmed S (1997) Normal umbilicus and infra-umbilical abdominal wall in bladder exstrophy. Br J Urol 80:672CrossRefPubMedGoogle Scholar
  39. Stein R, Stockle M, Fisch M (1994) The fate of the adult exstrophy patient. J Urol 152:1413–1416CrossRefPubMedGoogle Scholar
  40. Swana HS, Gallagher PG, Weiss RM (1997) Pseudoexstrophy of the bladder: case report and literature review. J Pediatr Surg 32:1480–1481CrossRefPubMedGoogle Scholar
  41. Wood BP (1990) Cloacal malformations and exstrophy syndromes. Radiology 177:326–327CrossRefPubMedGoogle Scholar
  42. Yazici M, Sözübir S, Kilicoglu G (1998) Three-dimensional anatomy of the pelvis in bladder exstrophy: description of bone pathology by using three-dimensional computed tomography and its clinical relevance. J Pediatr Orthop 18:132–135PubMedGoogle Scholar

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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Radiology, Division of Pediatric RadiologyMedical University GrazGrazAustria
  2. 2.Department of RadiologyHamad General HospitalDohaQatar

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