BLADDER EXSTROPHY FROM CHILDHOOD INTO ADULT LIFE

Exstrophy of the bladder is rare and the incidence of bladder exstroph y is calculated to be from 1 per 30 000 to 50 000 live births with mal e to female ratio ranging from 1.5-5 to 1(1-4). It was found that pers istence or overgrowth of the cloacal membrane on the lower anterior ab dominal area, prevents normal mesenchymal ingrowth. This causes diverg ence of the lower abdominal muscular structures and forces the genital ridges to fuse caudal to the cloacal membrane. The stage of ingrowth of the urorectal septum at the time of rupture determines whether one will produce an exstrophic urinary tract alone (classic bladder exstro phy or epispadias) or cloacal exstrophy with the hindgut interposed be tween the hemibladders(5,6).