Bladder Exstrophy

Etiology: Genital tubercle fuses caudad to distal aspect of urogenital sinus which leads to direct contact of urogenital sinus and anterior body wall
Imaging:
— Anterior abdominal wall is not fused inferiorly
— Bladder is not fused anteriorly and is everted
— Diastasis of symphysis pubis
DDX:
Complications: Vesicoureteral reflux, urinary tract infection, renal failure, carcinoma
Treatment: Immediate surgical closure of bladder and anterior abdominal wall defect
Clinical:
— More common in males than females
— Associated with epispadias

Radiology Cases of Bladder Exstrophy

AXR of bladder exstrophy — AXR shows diastasis of the symphisis pubis.

AXR of bladder exstrophy — AP radiograph of the abdomen (left) shows diastasis of the symphysis pubis. Lateral radiograph of the abdomen (right) shows a soft tissue mass protruding anteriorly out of the pelvis.

VCUG of grade V vesicoureteral reflux in a patient with bladder exstrophy — AP image from a voiding cystourethrogram shows reflux of contrast into extremely dilated renal collecting systems and ureters bilaterally. There is also diastasis of the symphysis pubis.

Clinical Cases of Bladder Exstrophy

Clinical image of bladder exstrophy — Clinical image shows the anterior abdominal wall is not fused inferiorly and that the bladder is not fused anteriorly and is everted and extending through the anterior abdominal wall defect.