Successful Pregnancy Outcome and Surgical Approach in Women with Repaired Bladder Exstrophy or Cloacal Exstrophy – Experience from a quaternary paediatric and adolescent gynaecology centre in Australia

Bladder exstrophy is a rare congenital anomaly, occurring in 2-3.3/100,000 births, with a male to female ratio of 3-4 to 1[1]. Cloacal exstrophy is even rarer compared to bladder exstrophy, with a prevalence of 0.76/100,000 births, with male to female ratio of 1:1.14. [2]. Classical bladder exstrophy is characterised by a defect in the closure of the lower abdominal wall and bladder, and is always associated with pubic bone diastases [3,4]. Whereas classical cloacal exstrophy typically refers to the combination of omphalocele, bladder exstrophy and imperforate anus, cloacal exstrophy can also be associated with renal malformations and spine defects [2]. Multiple surgeries are usually required to correct the congenital defects in those born with bladder exstrophy or cloacal exstrophy. Common surgeries include initial bladder closure, bladder neck reconstruction, enterocystoplasty, and neobladder creation with an ileal conduit. The Mitrofanoff procedure is commonly utilised method in which the appendix or the bowel act as a conduit between the bladder and skin surface. Continence is usually maintained with self- catheterisation [1,5-15].

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Author: Ying He

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