TY - CHAP M1 - Book, Section TI - Bladder Exstrophy A1 - Bianchi, Diana W. A1 - Crombleholme, Timothy M. A1 - D'Alton, Mary E. A1 - Malone, Fergal D. Y1 - 2015 N1 - T2 - Fetology: Diagnosis and Management of the Fetal Patient, 2e AB - Key PointsBladder exstrophy is a severe abnormality of the anterior abdominal wall in which the bladder protrudes under the umbilical cord, the pubic bones are separate causing rectus divergence, and frequently is associated with inguinal hernia.In females the mons, clitoris, and labia are separated, with hemiclitoris on either side of the bladder, and there is frequently duplication of the vagina and uterus.In males the penis is short and broad, with a dorsal urethral plate, dorsal chordee, and splayed glans.Bladder exstrophy is very rare, being seen in 1 in 3000 to 1 in 50,000 births, and there is a significant male preponderance.Prenatal sonographic diagnosis is possible by noting an absent bladder, but with normal amniotic fluid volume, together with a lower midline abdominal wall mass and abnormal appearing external genitalia.Pregnancy management is generally unchanged by the prenatal diagnosis of bladder exstrophy, and the only role for genetic amniocentesis is to assist in assignment of gender if external genitalia are unclear.The goal of surgical management is to achieve bladder closure, epispadias repair, and achievement of urinary continence; this can be achieved either in a three-stage process over 4 years or as a single primary repair.Bladder exstrophy is generally considered a sporadic abnormality, although there may be a 3%–4% recurrence risk in siblings. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - obgyn.mhmedical.com/content.aspx?aid=1106398818 ER -