Bladder exstrophy
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Bladder exstrophy
Pathology
Renal and ureteral disorders
Renal agenesis
Horseshoe kidney
Potter sequence
Hyperphosphatemia
Hypophosphatemia
Hypernatremia
Hyponatremia
Hypermagnesemia
Hypomagnesemia
Hyperkalemia
Hypokalemia
Hypercalcemia
Hypocalcemia
Renal tubular acidosis
Minimal change disease
Diabetic nephropathy
Focal segmental glomerulosclerosis (NORD)
Amyloidosis
Membranous nephropathy
Lupus nephritis
Membranoproliferative glomerulonephritis
Poststreptococcal glomerulonephritis
Goodpasture syndrome
Rapidly progressive glomerulonephritis
IgA nephropathy (NORD)
Lupus nephritis
Alport syndrome
Kidney stones
Hydronephrosis
Acute pyelonephritis
Chronic pyelonephritis
Prerenal azotemia
Renal azotemia
Acute tubular necrosis
Postrenal azotemia
Renal papillary necrosis
Renal cortical necrosis
Chronic kidney disease
Polycystic kidney disease
Multicystic dysplastic kidney
Medullary cystic kidney disease
Medullary sponge kidney
Renal artery stenosis
Renal cell carcinoma
Angiomyolipoma
Nephroblastoma (Wilms tumor)
WAGR syndrome
Beckwith-Wiedemann syndrome
Bladder and urethral disorders
Posterior urethral valves
Hypospadias and epispadias
Vesicoureteral reflux
Bladder exstrophy
Urinary incontinence
Neurogenic bladder
Lower urinary tract infection
Transitional cell carcinoma
Non-urothelial bladder cancers
Renal system pathology review
Congenital renal disorders: Pathology review
Renal tubular defects: Pathology review
Renal tubular acidosis: Pathology review
Acid-base disturbances: Pathology review
Electrolyte disturbances: Pathology review
Renal failure: Pathology review
Nephrotic syndromes: Pathology review
Nephritic syndromes: Pathology review
Urinary incontinence: Pathology review
Urinary tract infections: Pathology review
Kidney stones: Pathology review
Renal and urinary tract masses: Pathology review
Assessments
Bladder exstrophy
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Bladder exstrophy
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External References
First Aid
2017
Bladder exstrophy p. 591,344
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Transcript
Content Reviewers
Rishi Desai, MD, MPHContributors
Amanda J. Grieco, Ph.D.
Tanner Marshall, MS
Bladder exstrophy is a congenital abnormality that results in an “inside-out” bladder, where the bladder protrudes out of the abdomen, leaving the inside of the bladder exposed to the outside environment.
Normally, in the first trimester, endoderm in the hindgut expands to form the cloaca, which is a temporary structure that connects the urinary, digestive, and reproductive tracts. Separately, the ectoderm forms the anterior abdominal wall.
At around eight weeks of development three important things happen. First, the anterior abdominal wall matures and forms the muscles and connective tissue of the lower abdomen.
Second, the cloaca splits to form the urogenital sinus and rectum, the urogenital sinus later goes on to become the urinary and genital ducts, as well as the urinary bladder.
And third, the cloacal membrane opens up to the outside of the body, creating openings for the urogenital tract and anus.
All right, so bladder exstrophy occurs when the developing bladder and urethra herniate anteriorly and this causes some problems. First, it prevents the normal development of the lower abdominal wall which leaves it open.
Second, it prevents fusion of the pelvis leaving a wide split at the symphysis pubis.
Also, most cases of bladder exstrophy involve epispadias, which is where the urethra exits the top of the penis, but the opposite is not true, not all cases of epispadias involve bladder exstrophy.
Sources
- "Robbins Basic Pathology" Elsevier (2017)
- "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
- "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
- "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
- "Contemporary outcomes in bladder exstrophy" Current Opinion in Urology (2007)
- "Modern Management of the Exstrophy-Epispadias Complex" Surgery Research and Practice (2014)
- "Perioperative management of classic bladder exstrophy" Research and Reports in Urology (2013)
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