Exstrophy

Exstrophy is a congenital anomaly in which the bladder does not close completely during its development. With exstrophy, a child is born with the lower part of the anterior abdominal wall missing, and the inner surface of the posterior wall of the bladder is visible.

Exstrophy is often accompanied by epispadias, a congenital malformation of the urethra in which the external opening of the urethra is not located at the top of the penis, but on its lower surface. With exstrophy, complete urinary incontinence is also observed due to incomplete closure of the urethra.

In boys with exstrophy, very often the testicles do not descend completely into the scrotum due to disruption of their normal migration during fetal development. This leads to cryptorchidism - incomplete descent of one or both testicles.

Bladder exstrophy is a severe pathology that requires complex surgical treatment. With timely and correct treatment, the prognosis for the life and health of the child is generally favorable.

The question of the need for exstrophy is far from clear, since there is such a congenital anomaly as epispadias. With this defect, there are no pubic arches or the pubic symphysis, where the testicles should be located. At the same time, this is a serious anomaly of the genital organs. And then - okay, we could talk about exstrophy. But the main question, and that's where the argument should lie, is whether exstrophy can be done. Unfortunately, surgeons around the world have not yet solved this problem. After all, it is not only boys who cannot restore the integrity of their torso. It is made up of bones, soft tissues, blood vessels, and nerves. It turns out that experts are considering a defect of approximately the same complexity as rectal prolapse for people with dysfunction of the pelvic organs. However, the most important thing is that if muscle function is impaired, there is a chance for normal intestinal function. If the corresponding fragment is simply missing, then there is no hope for independent innervation and the act of defecation. Due to the difficulty of exstrophy, which is beyond the scope of clinical practice, what is especially scary is the gross role this pathology plays in the perception of gender. For your information, in translation from English “exstrophy” literally translates as “absence”. With exstrophy, the integrity of the muscle-articular complex is not preserved at all. But in the abdominal cavity it is very rare in men: 2-3% or 7 - 8 people out of a thousand. More often this anomaly occurs in girls (95-98%). Despite its frequency and ease of anatomical diagnosis, exstrophy is sometimes referred to as a speciesless term. And among doctors there is a thesis circulating in medicine - the same term “uterine atony” is used to describe an anechoic or hyperechoic formation in the space of Douglas, intermuscular gap, and bone marrow space.

Exstrophy is a congenital developmental disorder, which consists in the absence of the anterior wall of the bladder after the stage of primary formation of the pelvic organs; there is a lack of fascia between the anterior wall of the bladder and the pubic symphysis. In most cases it occurs in girls. When the process spreads to the abdominal cavity, it occurs as thoracoperineovaginoplasty.