All of the following are features of exstrophy of the bladder except:-
Correct Answer: Cloacal membrane is present
Description: Exstrophv of bladder (Ectopia vescicae)
There is a defect in the infraumbilical part of the anterior abdominal wall, associated with incomplete development of the anterior wall of the bladder.
The posterior wall of the bladder protrudes through the defect and urine spurts onto the abdominal wall from the uretral orifices.
The pubic rami are widely separated. The femurs are rotated externally and the child 'waddles like a duck'.
The rectus muscles which are inserted on the pubic rami are also widely separated.
An umbilical hernia though usually small is present along with extropic bladder.
In males, there is complete epispadias with a wide and shallow scrotum. Undescended testis and inguinal herniasare common.
Females also have epispadias, with separation of the two sides of the clitoris and wide separation of the labia.
The anus is dislocated anteriorly in both sexes and there may be rectal prolapse.
The consequence of untreated bladder exstrophy are total urinary incontinence and an increased incidence of bladder cancer, usually adenocarcinoma.
Embryology - The basic defect in the extrophy bladder is abnormal overdevelopment of the cloacal membrane and its rupture. The timing of the rupture of this defective cloacal membrane determines the variant of the exstrophy-epispadias complex that results.
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