ANATOMICAL BASIS OF A COMMON EMBRYOLOGICAL ORIGIN FOR EPISPADIAS AND BLADDER OR CLOACAL EXSTROPHIES

Epispadias, bladder exstrophy and its variants are in the first place usually considered as urological anomalies. Embryological theses and t herapeutic approaches are mainly based upon this aspect. We challenge this point of view, in order to bring out a new axis of research about this still misknown pathologic field. A review of 16 cases of bladder exstrophy, 6 epispadias cases, and one cloacal exstrophy case, which had never been described before, revealed that the almost constant bon y defect of the pelvic ring was linked with the severity of the viscer al features, and with the continence status in epispadias cases. The c ommonly admitted theories about exstrophy development are based on a p rimary defect of the cloacal membrane. We suggest that the first anoma ly could lie in a lack of rotation in the pelvic ring primordia.